Health care – Press Heraldhttps://www.pressherald.com
Mon, 19 Mar 2018 14:48:14 +0000en-UShourly1https://wordpress.org/?v=4.9.4FDA moves to lower nicotine levels in cigarettes to make them less addictivehttps://www.pressherald.com/2018/03/15/fda-moves-to-lower-nicotine-levels-in-cigarettes-to-make-them-less-addictive/
https://www.pressherald.com/2018/03/15/fda-moves-to-lower-nicotine-levels-in-cigarettes-to-make-them-less-addictive/#respondThu, 15 Mar 2018 16:04:50 +0000https://www.pressherald.com/2018/03/15/fda-moves-to-lower-nicotine-levels-in-cigarettes-to-make-them-less-addictive/WASHINGTON — The Food and Drug Administration on Thursday took the first concrete action to reduce nicotine in cigarettes to make them much less addictive, opening a regulatory process described as a “historic first step” by the agency’s top official.

Commissioner Scott Gottlieb unveiled an “advance notice of proposed rulemaking,” the earliest step in what promises to be a long, complicated regulatory effort to lower nicotine levels to be minimally addictive or nonaddictive.

The notice, to be published Friday in the Federal Register, includes new data published in the New England Journal of Medicine on Thursday based on a possible policy scenario. That FDA-funded analysis found that slashing nicotine levels could push the smoking rate down to 1.4 percent from the current 15 percent of adults. That in turn would result in 8 million fewer tobacco-related deaths through the end of the century – which Gottlieb termed “an undeniable public health benefit.”

The evaluation was based on reducing nicotine levels to 0.4 milligrams per gram of tobacco filler, FDA officials told reporters during a teleconference.

Many adults try to quit smoking each year but fail because nicotine is such an addictive substance, said Mitch Zeller, director of the FDA’s Center for Tobacco Products. Cutting the nicotine level would not only help them succeed, but it also could keep young people who may be experimenting with cigarettes from becoming addicted, he said.

The nicotine notice will be open for public comment for 90 days. FDA officials are seeking input on what the maximum nicotine level in cigarettes should be and whether such a limit should be implemented all at once or gradually. Nicotine levels can be manipulated by leaf blending, chemical extraction and genetic engineering.

Other critical issues that will need to be addressed, according to officials, include the potential for illicit trade in high-nicotine cigarettes and whether addicted smokers would compensate for lower nicotine levels by smoking more. After the comment period ends, officials will decide whether to move forward with a formal proposal.

Thursday’s action follows Gottlieb’s announcement last summer that the agency would pursue a comprehensive plan on tobacco and nicotine regulation in an effort to avert millions of tobacco-related deaths. Smoking is at an all-time low in the United States, and tobacco use among young people is also at historically low rates. Still, smoking causes 480,000 deaths annually in this country.

The 2009 Tobacco Control Act gave the FDA the power to regulate tobacco, though not to ban it.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, an antismoking group, said that Thursday’s action will have “enormous significance” – provided it is followed by quick FDA action to develop and adopt a final rule.

“It would be the most significant public health proposal we have seen from the U.S. government in the last 20 years,” Myers said. No regulatory agency in the world has seriously proposed reducing nicotine in cigarettes, he said.

“While this issue has been discussed conceptually for years, this is first time we have a government agency saying it is achievable, feasible and can be implemented in a way that doesn’t cause serious negative consequences,” Myers said.

Robin Koval, chief executive and president of Truth Initiative, another anti-tobacco group, also praised the effort, calling it a “a serious, strong response.” But it will be important for the FDA also to move forward on other fronts, she said, including on new e-cigarette rules that were delayed last summer by Gottlieb.

In discussing his comprehensive tobacco strategy on Thursday, Gottlieb said he sees “a historic opportunity” to use nicotine reduction as a way to move smokers from conventional cigarettes to products that provide nicotine without the serious health hazards posed by burning tobacco. Those alternative nicotine-delivery products include e-cigarettes or nicotine replacement therapies.

A spokesman for Philip Morris International said the company was still reviewing the agency’s advance notice. The firm previously had expressed support for Gottlieb’s nicotine regulation plan, which he said “encourages the development of innovative new tobacco products that may be less harmful than cigarettes.”

James Figlar, executive vice president of research and development for R.J. Reynolds Tobacco, said in a statement that he looks forward “to working with FDA on its science-based review of nicotine levels in cigarettes and to build on the opportunity of establishing a regulatory framework that is based on tobacco harm reduction and recognizes the continuum of risk.”

The FDA also said Thursday that it plans to soon issue two other advance notices: One on the role that flavors, including menthol, play in the use and cessation of use of tobacco products; and the other on the regulation of premium cigars.

]]>https://www.pressherald.com/2018/03/15/fda-moves-to-lower-nicotine-levels-in-cigarettes-to-make-them-less-addictive/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/03/cigarettes-e1521130137876.jpgThu, 15 Mar 2018 20:37:39 +0000Maine’s first radio show on cannabis aims to entertain, and ‘meducate’https://www.pressherald.com/2018/03/15/maines-first-radio-show-on-cannabis-hits-the-airwaves/
https://www.pressherald.com/2018/03/15/maines-first-radio-show-on-cannabis-hits-the-airwaves/#respondThu, 15 Mar 2018 08:00:00 +0000https://www.pressherald.com/?p=1347585Maine is now home to a cannabis-themed radio show, an hourlong mix of music and talk that is co-hosted by a high-profile medical marijuana caregiver.

Dawson Julia, the owner of a medical marijuana shop in Unity, will tackle a different topic every week on the Cannabis Connection, which airs from 6-7 p.m. on Mondays on WFMX-107.9 The Mix. He is joined by on-air personality Chris Rush and a different special guest each week, ranging from a state representative who works on state medical cannabis legislation to a nurse practitioner who certifies medical marijuana patients to a criminal defense lawyer.

Julia came up with the idea last year while listening to disc jockeys on the Augusta-based station talk about whether Maine cannabis users can buy a gun. (No, federally licensed firearms dealers can’t sell guns to people who use cannabis, even in states that have legalized it for recreational or medical use.) Julia said he was surprised at the open and honest nature of the on-air debate, and the level of interest from listeners who called the station to share their views.

“Nobody was talking stigma talk,” Julia recalls. “The question – would you give up your ganga for your guns – that got people’s attention, like a lot of cannabis stuff does, but really, people just wanted information. I thought, I can give them that. So yeah, we want to entertain them, but in between all the songs, we are gonna educate them, and hopefully, once they have the facts, we’re gonna activate them.”

Related

In January, station owner Jay Hanson said he was open to the idea of a cannabis-themed show so long as the station’s lawyer gave him the thumbs up. He thought that legalization of recreational marijuana in Maine had raised public interest. “You just knew Maine was going to do this, put this on the radio, it was just a question of when,” Hanson said at the time. “I think the time for it is now.”

The Cannabis Connection launched Feb. 19. In its first month, it has been a mix of pre-recorded and live segments, with about 20 minutes of talk spread over one hour, sandwiched between ads for Taunton Bay Soap Company and Waterville Opera House and songs by Selena Gomez and Lynyrd Skynyrd. The show’s main sponsor is Medical Marijuana Caregivers of Maine, a statewide trade group on whose board Julia sits.

On Monday, Julia welcomed Tom Ferris, a criminal defense attorney from Waterville, who talked about the federal prohibition on gun ownership for marijuana users and the uptick in people being charged with driving while high. Julia and Rush urged Ferris to educate listeners about the laws, but also weighed in with comments about the Draconian nature of what they believed to be unfair restrictions on consumers’ civil liberties.

“So I could have 100 cases of Jack Daniels in the back of my truck and it’s totally legal, but if I have more than 2.5 ounces of a plant that is not lethal, non-poisonous and pretty much non-addictive, I could be charged with a criminal charge?” Julia asked. When Ferris answered yes, something Julia already knew, Julia replied: “That’s crazy, if you ask me.”

While Julia would eventually like to expand the talk section of the show, he thinks the heavy music rotation will probably draw in some listeners who have no experience with cannabis at all, giving Julia and his guests the chance to deliver an auditory vaccine against what he likes to call “cannabis stigma syndrome disorder.” However, he doesn’t mind sprinkling the show with some wink-wink, nudge-nudge cannabis humor.

At the beginning of Monday’s show, listeners were welcomed by a famous clip from the 1970s parody, “Beyond The Valley of the Dolls,” where Porter Hall tells Susan Lake, “I wouldn’t be the least bit surprised to learn that all four of them habitually smoke marijuana cigarettes – reefers!” In between the Eddie Money songs, listeners also got a hit of Sublime’s “Smoke 2 Joints” and Dash Rip Rock’s “(Let’s Go) Smoke Some Pot.”

Results on the drug, Praluent, were announced Saturday at an American College of Cardiology conference in Florida. It’s the first time a cholesterol-lowering drug has reduced deaths since statins such as Lipitor and Crestor came out decades ago.

But the benefit was small – 167 people would need to use Praluent for nearly three years to prevent a single death.

“That’s a high cost” that may still hinder its use, said one independent expert, Dr. Amit Khera, a preventive cardiologist at UT Southwestern Medical Center in Dallas and a spokesman for the American Heart Association.

The drug’s makers, Sanofi and Regeneron Pharmaceuticals, said they would work with insurers on pricing to get the medicine to those who need it the most.

Doctors focus on lowering LDL, or bad cholesterol, to prevent heart problems. Statins are the main medicines for this, but some people can’t tolerate or get enough help from them.

Praluent and a similar drug, Amgen’s Repatha, work in a different way and lower cholesterol much more. Patients give themselves shots of the medicine once or twice a month.

The need for an influx of funding to the Jackman Community Health Center became urgent in June 2017 when MaineGeneral Health announced it no longer could afford to operate at the health center and pulled its overnight and weekend emergency services from the rural tourist town. MaineGeneral, which operated a nursing home at the center, and Penobscot Community Health Care, of which the Jackman facility is a part, had been pooling their resources to keep it open at night.

Penobscot has implemented an on-call system for nights and weekends so that a nurse, physician’s assistant and doctor could be available at the center if a patient were in need of immediate care. But without MaineGeneral’s funding, the operation of the on-call service is not sustainable and roughly 800 Jackman residents, as well as residents from the surrounding Moose River region, eventually would have to travel either 75 miles to Skowhegan or 50 miles to Greenville to receive emergency care.

The $150,000 that would go to the center if the Legislature passes the bill would be tied directly to the center’s budget and would provide on-call services to the region for the rest of the fiscal year.

Rep. Chad Grignon, R-Athens, a sponsor of the bill, has said Jackman’s status as a destination for outdoor recreation has added urgency to the funding situation. Thousands of tourists go to the area, which is just a few miles from the Canadian border, to snowmobile, hunt, fish and ride all-terrain vehicles. In recent months, several snowmobile and ATV accidents have been reported in the region.

In addition, Grignon said, a large number of people in the area work in the forestry industry, which is a dangerous job.

At Friday’s work session, Lori Dwyer, the president of PCHC, and Jackman Selectman Alan Duplessis went before the committee to offer testimony on the center’s need for the funding.

Dwyer said that although the original request was for almost $500,000, that figure has since been adjusted, and about $100,000 was raised from the community, so a one-time allocation of $150,000 would cover the rest of the financial shortfall.

Emily Higginbotham can be contacted at 861-9239 or at:

ehigginbotham@centralmaine.com

Twitter: @EmilyHigg

]]>https://www.pressherald.com/2018/03/09/panel-endorses-payment-to-jackman-health-facility/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/03/1345282_855814_jackman_location_201.jpgA bill that would help fund on-call medical service at the Jackman Community Health Center was voted out of committee unanimously and might come up for a vote in the full Legislature next week.Fri, 09 Mar 2018 22:12:11 +0000Dental board wants complaints against Lewiston oral surgeon heard in courthttps://www.pressherald.com/2018/03/09/dental-board-wants-complaints-against-lewiston-oral-surgeon-heard-in-court/
https://www.pressherald.com/2018/03/09/dental-board-wants-complaints-against-lewiston-oral-surgeon-heard-in-court/#respondSat, 10 Mar 2018 01:07:55 +0000https://www.pressherald.com/2018/03/09/dental-board-wants-complaints-against-lewiston-oral-surgeon-heard-in-court/AUGUSTA — Faced with the prospect of hearing two weeks’ worth of new testimony on the remaining charges levied against Lewiston oral surgeon Jan Kippax, the Maine Board of Dental Practice Friday agreed to ask a state court to handle the case instead.

In a unanimous vote, the panel agreed to ask a district court to decide what penalties Kippax should face following allegations he mistreated patients by ignoring their complaints about pain during surgery.

It is unclear when, if ever, the state might renew its effort to suspend or revoke Kippax’s license to practice. But an assistant attorney general said officials are still pressing ahead with it.

At one point in the session, one of Kippax’s former patients, Stuart Smith, asked if he could speak. After he was told he could not, Smith walked out after loudly denouncing Kippax as “a brutal sadist.”

The dental board has spent many hours over the past 13 months dealing with a litany of complaints filed against Kippax. Five of the most serious were brought to a hearing last fall that ultimately cleared the longtime dentist on 64 complaints brought by five patients.

But another 13 patients’ cases that include about 120 more specific allegations remain active.

Auburn lawyer James Belleau, who represents Kippax, sought to convince the panel to allow Dr. Mark Zajkowski of South Portland, a new member, to take another look at the remaining charges because he is an oral surgeon.

When the dental panel investigated the complaints against Kippax in 2016 and 2017, it did not have any oral surgeons among its nine members.

But dental overseers rejected that argument. They said Zajkowski would be more valuable as part of the panel hearing Kippax’s case. He could not do both.

Kippax was initially suspended from practicing dentistry more than a year ago when the board cited 18 cases in which it charged he acted unprofessionally.

In the end, however, it decided to hear only five of the patients in a hearing that started in late September and finished, with some long breaks between sessions, at the end of December.

Belleau said the decision to send Kippax’s case to court wasn’t proper because the law says a professional oversight board can only do that when it finds grounds for revoking or suspending a license.

He argued that after clearing Kippax of every charge it heard, the board can hardly maintain that there are grounds to penalize him so severely now.

“There was no basis to discipline him in the first place,” Belleau said.

But the panel sided with the advice of the hearing officer who has guided the proceedings since last April, Mark Terison.

Terison said he has “never seen a case like this” that demands so much from the members of the board in terms of their time and attention. He said the voluminous nature of the case is unusual.

Terison also pointed out that a judge could schedule a hearing and then plunge into it day after day until it was over. The dental panel, whose members have jobs and patients of their own, can only devote an occasional day or weekend to the task, so it winds up spread over the course of months.

Dr. Glen Davis, a board member, said it would be more practical for everyone to see the proceedings shifted to the courthouse.

Representatives from The Joint Commission, CMMC’s accrediting agency, revisited the hospital in January and February, several weeks after a regular visit found problems. Hospital leaders said The Joint Commission was satisfied with the hospital’s new infection control protocols and other changes.

“The surveyor said that she was very impressed with how much work we’d done,” Central Maine President David Tupponce said.

The hospital’s accreditation came under scrutiny in December after a routine accreditation survey found problems. The Joint Commission gave the hospital 30 days to improve and told it to work on three key areas:

• The processes involved in cleaning high-risk equipment;

• Using best practices to maintain a safe environment for patients and staff before, during and after care; and

• Encouraging and empowering staff to identify and correct situations that could put patients or staff in danger.

The Joint Commission’s concerns came the same month Medicare announced it was penalizing CMMC for high rates of infections and patient injuries. It was the second year in a row the hospital was penalized.

At the time, a hospital spokesman said it was working on its issues and fully expected to maintain its accreditation.

Hospital officials said this week that there have been several changes made, such as providing only individually wrapped eating utensils rather than unwrapped ones, and labeling which sinks are reserved for washing hands and which are reserved for washing medical instruments.

The hospital has also hired a director of infection prevention.

Because The Joint Commission routinely makes random, unannounced visits to ensure hospitals continue to meet its standards, CMMC officials expect additional site visits in the future.

ltice@sunjournal.com

]]>https://www.pressherald.com/2018/03/09/cmmc-keeps-its-accreditation-after-addressing-concerns-over-infections/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/12/Central_Maine_Medical_Center-534x462.jpgFri, 09 Mar 2018 23:20:32 +0000Rep. Poliquin, other lawmakers push for more funds to fight opioid crisishttps://www.pressherald.com/2018/03/08/rep-poliquin-other-lawmakers-push-for-more-funds-to-fight-opioid-crisis/
https://www.pressherald.com/2018/03/08/rep-poliquin-other-lawmakers-push-for-more-funds-to-fight-opioid-crisis/#respondFri, 09 Mar 2018 00:22:31 +0000https://www.pressherald.com/2018/03/08/rep-poliquin-other-lawmakers-push-for-more-funds-to-fight-opioid-crisis/Maine collected only 40 cents of every $100 allocated by the federal government under a $1 billion program approved in 2016 to assist states trying to deal with the opioid crisis.

For some, including U.S. Rep. Bruce Poliquin of Maine, that doesn’t seem fair.

The 2nd District Republican and other lawmakers are pressing the Labor, Health and Human Services Subcommittee of the House Appropriations Committee to revise the formula used to distribute the money so that small states with big problems – including Maine, West Virginia and New Hampshire – get more aid, said Brendan Conley, Poliquin’s spokesman.

Maine saw 418 people die of overdoses in 2017, an 11 percent increase over the previous year, according to the Maine Attorney General’s Office. Most were caused by opioids as fentanyl overtook heroin as the drug causing the most deaths. Nationally, there were more than 63,000 drug-related deaths in 2016, the latest year that data was available. That was a 20 percent increase over the previous year.

“Maine has tragically been disproportionately impacted by the opioid epidemic, as so many of our families and communities throughout the state have been hurt by this crisis,” Poliquin said in a prepared statement.

He said the federal government needs “to get support to the states and to local officials,” including the money appropriated under the 21st Century Cures Act during President Obama’s final year in office.

In the first year of the program, Maine got $2 million of more than $485 million handed out under the program. It expects to receive about the same when the second-year distribution is made in the spring. Maine’s allocation almost exactly matches its share of the overall national population.

Though many called for a revised formula, the Trump administration announced in late October it would stick with the existing formula for the second year’s aid distribution.

The U.S. Department of Health and Human Services said the formula it used to allocate the funds “takes into account the needs of each jurisdiction, including the number of overdose deaths and people with an unmet need for treatment.” It also said that many states asked for funding levels to remain the same “to ensure continuity of services to people needing treatment.”

Reps. Ann Kuster, D-N.H., and Evan Jenkins, R-W.Va., introduced the Federal Opioid Response Fairness Act, a bill that seeks to revise the formula to boost assistance for smaller states. Poliquin is a co-sponsor.

Kuster and Jenkins said the formula used to hand out the money relies too heavily on population rather than taking into account that some states with smaller populations were suffering disproportionately.

Poliquin and the others hope to convince colleagues on the appropriations panel to include the formula changes in a spending bill to fund the government through the rest of the 2018 fiscal year.

Because the measure has to pass, “the lawmakers see this as a conceivable way” to have their formula adjustments implemented, Conley said.

A Senate bill taking aim at the same issue has eight co-sponsors, including Maine independent Sen. Angus King. King is also backing another proposal that would add $10 billion to the effort during the next five years.

“As the opioid epidemic continues to ravage communities in Maine and across the country, the federal government’s response has not matched the severity of the threat,” King said in a prepared statement.

Poliquin, a founding member of the Bipartisan Heroin Task Force in Congress, has come under heavy criticism from Democrats who say he’s done too little to combat the opioid crisis in his home state.

But Poliquin maintains he’s done everything he can to devote resources and attention to the issue.

“As someone who grew up in a health care family with my mother working as a nurse and having lost my own brother to substance abuse, I understand firsthand the seriousness and horror of this epidemic in Maine,” Poliquin said.

scollins@sunjournal.com

]]>https://www.pressherald.com/2018/03/08/rep-poliquin-other-lawmakers-push-for-more-funds-to-fight-opioid-crisis/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/03/1091843_936763-20160830-poliquin-5-e1490373770456.jpgU.S. Rep. Bruce Poliquin, R-2nd District, makes a point about fair trade Aug. 30 at Auburn Manufacturing.Thu, 08 Mar 2018 20:06:20 +0000Genetic testing company gets OK to report cancer risk to consumershttps://www.pressherald.com/2018/03/06/genetic-testing-company-gets-fda-approval-to-report-cancer-risk-to-consumers/
https://www.pressherald.com/2018/03/06/genetic-testing-company-gets-fda-approval-to-report-cancer-risk-to-consumers/#respondWed, 07 Mar 2018 02:39:13 +0000https://www.pressherald.com/2018/03/06/genetic-testing-company-gets-fda-approval-to-report-cancer-risk-to-consumers/The direct-to-consumer genetic testing company 23andMe has received federal approval to inform people of breast cancer risk linked to three gene mutations, making it the first company allowed to test for cancer risk without a prescription in the United States.

The Food and Drug Administration decision is a step forward for the evolving world of consumer genomics. The company can report back the three mutations in the BRCA1 and BRCA2 genes that are the most common in the Ashkenazi Jewish population. But those mutations are not the most common BRCA mutations in the broader population.

In a prepared statement, Donald St. Pierre, acting director of the office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health, called the approval a step forward with “a lot of caveats.”

“Most BRCA mutations that increase an individual’s risk are not detected by this test,” St. Pierre said. “The test should not be used as a substitute for seeing your doctor for cancer screenings or counseling on genetic and lifestyle factors that can increase or decrease cancer risk.”

23andMe previously included breast cancer risk in its genetic tests in the U.S., but stopped in 2013 after the FDA sent the company a warning letter stating the company was marketing its test without approval. Anne Wojcicki, co-founder and chief executive of 23andMe, said the company’s experience selling the test before 2013 in the U.S., United Kingdom and Canada had provided insight into how useful the information can be, particularly to customers who did not realize they had Ashkenazi Jewish heritage.

She said that although the company hasn’t yet announced specific cancer risk mutations that it will add in the future, the approval surmounts a major hurdle.

Direct-to-consumer genetic tests have typically raised concern because of fears that people may not understand the information and panic or might be falsely reassured. Any person who comes back with a negative for these three gene mutations, for example, could still carry other mutations in the BRCA genes that elevate their cancer risk. They could also face elevated breast cancer risk due to other gene variations or other factors.

Robert C. Green, a medical geneticist at Brigham and Women’s Hospital, said the FDA’s decision was somewhat surprising, but gratifying – and a step forward in democratizing genomic information.

Green has studied how people handle information about genetic disease risks, and said that while the information can be upsetting, it can empower people to take actions.

“I don’t want to trivialize the potential for serious psychological burden that this risk information might provide; however, it is risk information that we know can lead to life saving interventions,” Green said. “So you have to balance that against the distress people might feel.”

]]>https://www.pressherald.com/2018/03/06/genetic-testing-company-gets-fda-approval-to-report-cancer-risk-to-consumers/feed/0https://multifiles.pressherald.com/uploads/sites/4/2016/10/1093813_Breast-Cancer-Mammograms.JP_.jpgMammograms can lead to overdiagnosis and overtreat- ment, says a new study.Tue, 06 Mar 2018 22:53:04 +0000Opioids no better at relieving chronic pain than common painkillers, study findshttps://www.pressherald.com/2018/03/06/opioids-no-better-at-relieving-chronic-pain-than-common-painkillers-study-finds/
https://www.pressherald.com/2018/03/06/opioids-no-better-at-relieving-chronic-pain-than-common-painkillers-study-finds/#respondTue, 06 Mar 2018 18:34:14 +0000https://www.pressherald.com/2018/03/06/opioids-no-better-at-relieving-chronic-pain-than-common-painkillers-study-finds/Doctors and patients have long assumed that opioids are uniquely powerful medicines for chronic pain, despite their risks. But it turns out that this reputation may be a myth.

A government-funded study published Tuesday is among the first long-term studies to compare opioids like oxycodone and morphine to common painkillers such as acetaminophen in patients with chronic back pain and arthritis, researchers said.

After a year of treatment, opioids weren’t any better at improving pain related to daily functioning, such as ability to sleep and work, the study found. The opioids were also slightly inferior at controlling pain intensity, and patients on them reported many more side effects, according to the results published in the Journal of the American Medical Association.

“The fact that opioids did worse is really pretty astounding,” said Roger Chou, an internist at Oregon Health & Science University and a co-author of Centers for Disease Control and Prevention guidelines on opioid use for chronic pain, who was not involved in the recent study. “It calls into question our beliefs about the benefits of opioids.”

Related

The findings run counter to years of medical practice in the U.S., where more so than in other countries, opioids have been prescribed to millions of patients for chronic pain over the years – even though data on their long-term effectiveness was lacking. While doctors are pulling back now, a surge in opioid use and abuse has led to an overdose crisis that kills tens of thousands of Americans each year.

The study is also another blow for opioid manufacturers, such as Purdue Pharma LP, that are already facing hundreds of lawsuits filed by U.S. cities and counties over their role in the opioid crisis. More than 300 lawsuits are on hold as the drugmakers engage in settlement talks ordered by the federal judge in Cleveland who is overseeing the litigation.

In the study, lead author Erin Krebs and her colleagues at the Minneapolis Veterans Affairs Health Care System randomly assigned 240 patients with chronic back pain, or hip or knee arthritis, to be treated either with opioid painkillers like morphine and oxycodone, or nonopioid medicines including standard anti-inflammatory drugs like naproxen, or topical analgesics such as lidocaine.

After a year, about 60 percent of patients in each group experienced significant improvements in their ability to perform daily functions without pain interfering. But pain intensity improved significantly in just 41 percent of patients in the opioid group, compared with 54 percent in the nonopioid group, said Krebs, a primary care doctor at the Minneapolis VA. And patients taking opioids reported experiencing twice as many side effects.

If anything the study should have been biased in favor of the opioids, researchers said, because patients knew what drugs they were getting, and many went into the study believing that opioids were better.

The results “will be surprising for a lot of people,” Krebs said. “Opioids have this reputation as powerful painkillers and I don’t think it is well deserved, at least for chronic pain.”

While opioids provide potent relief for acute pain, that doesn’t necessarily translate to a chronic pain situation, where the pain often becomes disassociated from the original injury. Long-term studies haven’t been required for regulatory approval of their sales, and drugmakers have had no incentive do any.

The 2016 CDC chronic pain guidelines co-authored by Chou, the Oregon university internist, found that most controlled studies of opioids lasted less than six weeks. The government agency concluded there was “insufficient evidence” for their long-term benefits, but plenty of evidence for harm.

“This the first randomized trial that demonstrates you do not need opioids for these common chronic pain conditions, that common drugs are as good,” said Gary Franklin, a neurologist and occupational health researcher at the University of Washington who did early studies linking prescription opioid use to fatal overdoses. “That is why this is so important.”

With assistance from Bloomberg’s Jef Feeley.

]]>https://www.pressherald.com/2018/03/06/opioids-no-better-at-relieving-chronic-pain-than-common-painkillers-study-finds/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1330202_Purdue_Pharma_Opioids_8372.jpgFILE - This Feb. 19, 2013 file photo shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. The maker of the powerful painkiller said it will stop marketing opioid drugs to doctors, a surprise reversal after lawsuits blaming the company for helping trigger the current drug abuse epidemic. OxyContin has long been the world's top-selling opioid painkiller and generated billions in sales for privately-held Purdue. (AP PhotoTue, 06 Mar 2018 13:40:48 +0000Oral surgeon asks Maine dental board to drop chargeshttps://www.pressherald.com/2018/03/06/oral-surgeon-asks-dental-board-to-drop-charges/
https://www.pressherald.com/2018/03/06/oral-surgeon-asks-dental-board-to-drop-charges/#respondTue, 06 Mar 2018 05:30:12 +0000https://www.pressherald.com/2018/03/06/oral-surgeon-asks-dental-board-to-drop-charges/AUGUSTA — Lewiston oral surgeon Jan Kippax is asking the Maine Board of Dental Practice to consider dropping all of the remaining charges levied against him early last year.

The panel determined in December that the state failed to prove that Kippax had acted unprofessionally in his treatment of five patients, dismissing every allegation brought to a hearing after two experts testified he had not done anything wrong.

But there are 13 other patients whose allegations are still pending.

One of them, Donna Deigan, said a state investigator spoke with her this year about her experience with Kippax. She said he told her there was an active effort to try to make a case against the longtime dentist.

The dental panel is slated to consider a motion Friday from Kippax to reconsider its decision in February 2017 to suspend him, a move that also included bringing charges from 18 patients who accused him of mistreating them. Kippax is asking the dental overseers to clear the remaining cases.

The board’s agenda also includes an adjudicatory presentation by the hearing officer who has been dealing with the Kippax case. That’s slated to occur after Kippax’s motion is dealt with.

Deigan said recently she hopes the panel will give her a chance to testify against Kippax.

She said she went to him shortly after Christmas in 2014 so he could extract a tooth that had gone bad.

Deigan said he wouldn’t give her enough pain medicine to help and proceeded to yank one of her front teeth while she screamed.

In the board’s notice of hearing, Deigan is identified only as “D.D.” – who filed what it called “Complaint 16-38” sometime in early 2016.

After an investigation, the state determined Kippax treated her between Dec. 29, 2014, and Jan. 7, 2015, and allegedly committed nine transgressions worth noting, including performing extractions without proper consent, continuing a “painful dental procedure” despite a patient instructing him to stop or expressing distress, and failing to keep proper records for consult with her referring dentist.

Her complaints are similar to the ones the dental board heard during five days of hearings late in 2017 – charges it dismissed for lack of proof.

The Maine Attorney General’s Office is responsible for making the case against Kippax, who has been allowed to practice for nearly a year while the charges are pending. But his attorney said the dentist has had a hard time making a living because of the publicity surrounding the allegations and the state’s refusal to pay for Medicaid patients to see him.

The board initially suspended Kippax more than a year ago, but it could only prevent him from practicing for 30 days unless it held a hearing that found he had violated professional standards. It didn’t end up beginning a hearing until the end of September, well after he had reopened his Lewiston office.

Kippax is also licensed to practice in Massachusetts and Vermont.

The dental panel is scheduled to discuss Kippax’s motion at 1 p.m. Friday at the board’s office at 161 Capitol St. in Augusta. The session is public.

Steve Collins can be contacted at:

scollins@sunjournal.com

]]>https://www.pressherald.com/2018/03/06/oral-surgeon-asks-dental-board-to-drop-charges/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/03/1342820_465237-Jan-Kippax-Oral-Sur.jpgDr. Jan Kippax at a session of the Maine Board of Dental Practice.Tue, 06 Mar 2018 00:44:32 +0000For the past 11 years, Maine nurse has treated lung cancer patients – now she is onehttps://www.pressherald.com/2018/03/04/for-the-past-11-years-maine-nurse-has-treated-lung-cancer-patients-now-she-is-one/
https://www.pressherald.com/2018/03/04/for-the-past-11-years-maine-nurse-has-treated-lung-cancer-patients-now-she-is-one/#respondSun, 04 Mar 2018 09:00:00 +0000https://www.pressherald.com/?p=1341826HEBRON — The last weekend in October, Amy Richard started coughing.

A bad cold was going around, but her cough lasted longer than most. Days, then weeks, then a month.

An inhaler, the steroid Prednisone and two courses of antibiotics didn’t help. A chest X-ray showed fluid around her right lung but little else. A test of the fluid didn’t turn up anything out of the ordinary. Neither did a second test.

Meanwhile, fluid clogged Richard’s lung, making it difficult for her to work, care for her two young children or, sometimes, even to breathe. Doctors said she had bronchitis, then, they thought, pneumonia.

“I’m a nurse, so cancer was always on the radar for me, but it was at the bottom of the list,” she said.

At the bottom because Richard was only 41, a nonsmoker with no exposure to any of the things medical professionals typically think of: asbestos, radon, secondhand smoke, pollution. She knew all of that because she’s one of those medical professionals.

For the past 11 years, Richard has helped treat lung cancer patients in Lewiston.

In January, she became one of them.

“I want people to know that it can happen to anybody,” Richard said. “I never in a million years thought I would have lung cancer.”

‘WHY WOULD YOU HAVE THAT?’

Lung cancer has a stigma.

Unlike many other cancers, it’s often linked to a behavior: smoking. So patients get blamed for bringing it on themselves.

Experts estimate that about 20 percent of lung cancers are found in nonsmokers. Some have been exposed to other carcinogens, such as asbestos and radon.

Others, like Richard, have a genetic mutation.

As lung cancer often does, hers developed silently, unnoticed. Even when she started coughing, no one was alarmed – including her Central Maine Medical Center co-workers, the people who deal with lung cancer every day.

“I thought she had bronchitis and it was just going to be a viral thing and it would go away,” said Danielle George, a longtime friend and a physician assistant who works with Richard at Central Maine Cardiothoracic and Vascular Surgery. “I’ll tell you, I get a cough like that every spring and I never think anything about it.”

Richard’s boss, cardiothoracic surgeon Carmine Frumiento, didn’t even realize Richard was sick. She might have mentioned she had a cold, he said, but she didn’t complain about being weak or not feeling well. She was the same ultra-competent nurse, the same office “linchpin,” that she always had been.

At work at Central Maine Medical Center in Lewiston, nurse Amy Richard, center, chats with Danielle George, a physician assistant, as Carmine Frumiento, a cardiothoracic surgeon, sits on the edge of her desk. Photo by Andree Kehn/Sun Journal

Then, one day in December, Frumiento was driving to New York when one of his physician assistants texted him a picture of a chest X-ray. It was Richard’s, and her right lung was filled with fluid.

“It was clearly grossly abnormal. You could figure that out on a 3-by-5 screen on my phone,” he said. “I first thought to myself, ‘Common things are common, so she just has a pneumonia with fluid collection.’ ”

But when Frumiento arrived in New York, he experienced his first trickle of dread.

“As I kept staring at the film after I was out of my car, staring at my phone … as a surgeon, we’re trained to rule out the things that are going to kill you or do you harm, and if it’s not that, then we can worry about what it is. So that kind of kicked in,” he said.

“I always think in worst-case scenarios. It started occurring to me, well, is this really all fluid? Why would she have all this? She didn’t really look that sick. I kept trying to hang on to the idea that common things are common and she just had a pneumonia and this was secondary to a pneumonia and we’re going to be good. But at the same time, in the back of my head, was that this was extremely odd.”

A CT scan a few days later supported a pneumonia diagnosis. But again, something didn’t seem right. The scan showed a thickening or lumpiness on her chest wall.

It could easily have a benign explanation. Given Richard’s age, health and nonsmoking history, everyone leaned toward it being harmless.

“Were we just too hopeful? I don’t know,” Frumiento said.

Regardless, the next steps would be the same whether or not they suspected cancer. Doctors drained the fluid and sent it for testing, twice. It came back negative for cancer cells both times – not a definitive ‘no’ to cancer, because cells could have been missed, but it was a good sign.

A pulmonologist prescribed antibiotics and steroids. The medication didn’t help at all. Work was becoming harder. Caring for her 6-year-old daughter and 2-year-old son was becoming harder.

“Do you think I could have cancer?” she asked George, the PA and one of her closest friends.

“Why would you have that? You’re a nonsmoker, you’re healthy,” George told her. “I just don’t think that could be it.”

A second CT scan showed that the lumpiness hadn’t improved. In fact, it might have gotten a little worse.

Frumiento scheduled surgery for late January. His plan – his hope – was to clean out the infection.

“Of course, in the back of our minds is, ‘This just doesn’t look right up there. I don’t know what it is,’ ” he said. “What we told Amy, which is what we were hoping and what I still thought the odds-on diagnosis was, this was an infection.”

But as Frumiento slid a tiny camera through an incision in Richard’s chest, he immediately knew this was no infection. Rather than puss, he found growths along her chest wall and lung.

Within about 20 minutes, the hospital lab confirmed cancer. In part because the growths had expanded beyond her lung and onto her chest wall, it looked like stage 4.

George, who’d been assisting with her friend’s surgery, began to cry.

“When she was waking up in the operating room, I couldn’t even look at her,” George said. “I had to stay in the back of the room because I didn’t want her to see my face before we told her because I knew she would know.”

‘EMOTIONAL ROLLER COASTER’

In the hospital waiting room, Chris Richard waited to hear about his wife of seven years. When Frumiento walked in, he quickly realized the news was bad.

“My world,” he said, “was destroyed.”

Amy Richard got the news from Frumiento a few minutes later as she lay in her hospital room recovering from anesthesia, her parents, husband and George beside her.

“All I remember is the word adenocarcinoma,” she said. “I thought I was still dreaming at first.”

For the next couple of days, everyone remained dazed. Her husband felt like he was existing in a long, dark tunnel. Richard struggled not only with the terrifying possibility of dying and leaving her children without a mother, but also with the surrealness of having stage 4 lung cancer.

Chris Richard sits with his wife, Amy, in their home in Hebron. Photo by Andree Kehn/Sun Journal

“All of a sudden I go from being a caregiver to being a patient of my friends and work family,” she said. “It’s just so strange.”

But Richard believes she’s lucky, too.

The surgery was on a Tuesday, and by Friday she was on her way to Massachusetts General Hospital in Boston for a second opinion and to talk with some of the country’s best specialists – thanks in no small part to her medical connections.

She had her husband for support, but she also had George, who traveled to Boston with them to take notes. Before the trip, George and Frumiento met to list all of the questions she should ask so the couple wouldn’t have to be responsible for getting the right information amid their shock.

Doctors told Richard that her cancer would respond best to a promising new gene-target therapy – one pill a day, no chemo or radiation. Patients can develop a resistance to the medication over time, but it’s generally effective in the beginning.

“Something around 70 percent of the time it works. That’s not 100 (percent), but you know what? I’ll take it,” Richard said.

But her insurance ruled the medication was too new and refused to pay for it unless she tried an older treatment first. That older treatment would have to fail.

“Meaning either my cancer progresses, which I don’t really want to take that chance, obviously, or I have side effects I can’t tolerate,” Richard said.

But neither could her family afford the medication’s $12,000-a-month price tag.

With help from her doctors and their staff, she appealed the insurance company’s decision. And won. Richard started taking her new medication last week.

“All of this, it’s just been like an emotional roller coaster,” Richard said.

Co-workers and friends have helped with meals, diapers and child care. Family members set up a web page – FightLikeAMother.net – and created a crowdfunding page at YouCaring.com to raise money to help pay for Richard’s medical expenses not covered by insurance, travel to Boston and time off work. They had hoped to raise $5,000. So far they’ve raised more than $22,000.

The organizers of the Celebration of Courage Co-ed Hockey Tournament recently decided to make Richard the beneficiary of this year’s games. The tournament will be held March 10 and 11 at the Norway Savings Bank Arena in Auburn.

Chris Richard has played in the tournament for years for families dealing with cancer. This year he’ll play for his own.

“After we got over Mass. General, that really hit us,” he said. “After that, it’s been so positive. Great energy. We’ve had a lot of support. We’re continuing to get more support.”

Amy Richard is concerned about the cancer patients who don’t have all that support.

“I can’t speak highly enough of everyone at CMMC, my work friends and family. At this point I literally call them family. They worked so hard to get me the best care. I mean, you still have to advocate for yourself as a patient, but I worry about people who don’t have connections,” Richard said.

She hopes going public about her cancer diagnosis – in the newspaper, on Facebook, on the website her family created – will help raise awareness of the resources that are there.

The Dempsey Center, based in Lewiston, provides education, counseling, support and therapies including massage and acupuncture, to cancer patients and their caregivers. Some hospitals, including Central Maine Medical Center, have an oncology navigator who helps cancer patients get appointments with specialists, find resources in the community and generally work through the system. CMMC has a partnership with Mass. General, allowing patients quicker and easier second opinions and appointments with specialists.

“And they can talk to us,” Chris Richard offered.

Amy Richard also hopes her story will raise awareness that lung cancer can happen to anyone, even young nonsmokers. It’s a fact she’d never fully realized herself – until she was diagnosed.

“There’s such a stigma out there, and I was honestly one of the worst ones, being a nurse,” she said. “The majority of the patients I care for had a long smoking history. I’ve seen maybe one other case in the years I’ve been working of someone young, sort of, in this age group.”

While guidelines call for lung cancer screenings for older Americans who smoked – Richard’s medical office runs some of those screenings and will host an informational table at the hockey tournament – screenings of young nonsmokers are rare. Because of that, the cancer is typically advanced when it is found. Like Richard’s stage 4.

These days, she works mornings only because she’s too tired and too often out of breath to feel good in the afternoons. But during those mornings, she’s the same steadfast, compassionate nurse she’s always been.

“The diagnosis was hard on everybody,” George said. “Nobody knew what to do without her. She’s that rock in the office and I think it was hard. ‘What do we do without Amy?’ Everybody sees her and they can focus and say, ‘OK, she’s OK.’ Because if you look at her, you would never know. She looks like the same old Amy.”

It is likely Richard’s cancer will never go away. Doctors have told her that the genetic mutation cannot be passed down to her children, but it has altered her body forever and she will always carry cancer cells. The goal is to get her lung cancer under control, turning it into a chronic disease she can live with until better treatment – or a cure – comes along.

She refuses to feel sorry for herself or to consider any future other than one in which she’s there for her family.

“To me it’s like a challenge,” she said, cuddling her daughter, Olivia. “I know I can overcome this on some level. I’m not ready to leave my kids.”

“It’s not going to happen, anyway,” her husband added. “Nope.”

Lindsay Tice can be contacted at:

ltice@sunjournal.com

]]>https://www.pressherald.com/2018/03/04/for-the-past-11-years-maine-nurse-has-treated-lung-cancer-patients-now-she-is-one/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/03/1341826_CITamyrichardP02XX-2.jpgAmy Richard at home in Hebron with her children, Owen, left, and Olivia. Richard, 41, who is a nonsmoker, has been diagnosed with stage 4 lung cancer.Sun, 04 Mar 2018 09:07:33 +0000Uber drives deeper into health care markethttps://www.pressherald.com/2018/03/01/uber-drives-deeper-into-health-care-market/
https://www.pressherald.com/2018/03/01/uber-drives-deeper-into-health-care-market/#respondFri, 02 Mar 2018 00:29:29 +0000https://www.pressherald.com/2018/03/01/uber-drives-deeper-into-health-care-market/Uber is driving deeper into health care by offering to take patients in every U.S. market where it operates to their next medical appointment.

The ride-hailing service said Thursday its Uber Health business will handle rides set up by doctor’s offices or other health care providers and then bill that business, not the patient, for the service. The company said rides can be set up within a few hours or days in advance. Patients won’t need access to a smartphone to use the service.

Uber began testing the service last summer. More than 100 health care providers have signed up, including hospitals, clinics and physical therapy centers.

Company leaders said they are expanding because there’s a need. They cite federal government research that estimates that more than 3 million people do not obtain medical care because of transportation problems.

“There are a lot of people out there who are not going to the doctor simply because they can’t physically make it there,” Uber Health executive Jay Holley said.

He added that the service also represents a business opportunity for Uber by connecting the company with a lot of first-time users.

Uber will bill care providers who sign up for the service monthly based on their usage. Holley said some may pass the cost on to their customers, but most of the providers it has worked with so far pay for the rides out of their operating budget.

Uber rival Lyft offers a similar service called Concierge, which allows health care providers to set up rides for patients to get to appointments. The providers pay for the rides. Lyft also has patient transport partnerships with larger health care providers.

Health insurers and others have long recognized the need to help some patients, especially those with low incomes, make their medical appointments.

Molina Healthcare Inc. has offered a transportation benefit to its customers for around 25 years and says that more than 3 million people are eligible.

]]>https://www.pressherald.com/2018/03/01/uber-drives-deeper-into-health-care-market/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/03/1340444_Uber_Health_Care_62816.jpg-.jpgUber is offering to take patients to their medical appointments.Thu, 01 Mar 2018 21:45:52 +0000Three new flu deaths in Maine, but data indicate cases on declinehttps://www.pressherald.com/2018/02/28/three-new-flu-deaths-in-maine-but-data-indicate-cases-on-decline/
https://www.pressherald.com/2018/02/28/three-new-flu-deaths-in-maine-but-data-indicate-cases-on-decline/#respondWed, 28 Feb 2018 16:01:39 +0000https://www.pressherald.com/2018/02/28/three-new-flu-deaths-in-maine-but-data-indicate-cases-on-decline/Influenza cases declined for a third consecutive week in Maine, signaling that the worst of flu season might be over.

The state had 636 new flu cases for the week ending on Feb. 24, for a total of 5,625 for the 2017-18 season, according to the Maine Center for Disease Control and Prevention. Flu is far more prevalent than the numbers show, because most people recover at home while the statistics reflect people who test positive for the virus. The total number of cases is almost certain to surpass the 5,830 from the 2016-17 flu season. Flu season typically runs from October to May.

Flu cases climbed steadily through Feb. 3, when cases apparently peaked at 876 for that week. Cases fell slightly to 831 for the week ending Feb. 10, then dropped to 793 the next week before falling to 636 in the week ending Feb. 24.

Flu is notoriously unpredictable, and there could be other surges. Nationally, this season has been among the worst in recent years, with flu widespread through the continental United States. There had been 161,129 reported cases through Feb. 17, the most recent federal data available. Flu cases have also declined nationally the past two weeks.

In Maine, there were three new deaths in the most recent week, bringing total deaths to 55 for the 2017-18 season.

The predominant strain that’s circulating is influenza A, H3N2, a virulent strain that’s more likely to result in hospitalizations.

The flu vaccine is 36 percent effective this season, according to the U.S. CDC.

Public health officials strongly recommend getting a flu shot every season despite the varying effectiveness of the vaccine year-to-year.

For those who get a flu shot and still contract influenza, symptoms tend to be milder and not last as long, research has shown. The vaccine is never 100 percent effective because the flu virus is always mutating. In order to get the vaccine on the market in time, scientists must predict months in advance the predominant strains of flu that will be circulating. The vaccine was 48 percent effective in 2016-17 and 59 percent effective in 2015-16, according to the federal CDC.

The Justice Department also filed a statement of interest in a case involving hundreds of lawsuits against opioid manufacturers and distributors. Sessions said the Justice Department will argue that the federal government has borne substantial costs from the opioid epidemic and it seeks reimbursement. The case includes numerous cities, municipalities and medical institutions.

“Opioid abuse is driving the deadliest drug crisis in American history,” Sessions said at a news conference with several U.S. attorneys. “It has strained our public health and law enforcement resources and bankrupted countless families across this country.

Sessions’ announcement is part of a flurry of activity this week at the White House, on Capitol Hill, in a U.S. courthouse and elsewhere that may mark the beginning of an intensified federal effort to address the uncontrolled drug epidemic sweeping the country.

Related

States and cities have suffered the brunt of the cost and carnage of the drug crisis, which killed more than 64,000 people in 2016 and is straining local emergency and health services. About two-thirds of the overdose deaths were caused by opioids, in particular illicit fentanyl.

This week, the White House is holding a summit on the drug crisis, hearings on eight House bills are beginning on Capitol Hill and the Secretary of Health and Human Services has embraced the expansion of medically assisted drug treatment – in contrast to his predecessor.

In Ohio, a federal judge overseeing hundreds of lawsuits against drug companies may rule by Monday on whether the Drug Enforcement Administration must give plaintiffs and defendants years of data on prescription opioid painkillers that were poured into communities across the country. Overprescribing by doctors and that uncontrolled supply of pills are widely blamed for the start of the epidemic.

President Trump declared the opioid epidemic a “health emergency” in October, but cities overwhelmed by the crisis have complained that there has been little action or money from Washington in the months since.

]]>https://www.pressherald.com/2018/02/27/justice-department-to-target-opioid-manufacturers-distributors/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1330202_Purdue_Pharma_Opioids_8372.jpgFILE - This Feb. 19, 2013 file photo shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. The maker of the powerful painkiller said it will stop marketing opioid drugs to doctors, a surprise reversal after lawsuits blaming the company for helping trigger the current drug abuse epidemic. OxyContin has long been the world's top-selling opioid painkiller and generated billions in sales for privately-held Purdue. (AP PhotoTue, 27 Feb 2018 14:59:13 +0000As overdose deaths soar, LePage says he’s adding treatment beds at Windham prisonhttps://www.pressherald.com/2018/02/23/as-overdose-deaths-soar-lepage-says-hes-adding-treatment-beds-at-windham-prison/
https://www.pressherald.com/2018/02/23/as-overdose-deaths-soar-lepage-says-hes-adding-treatment-beds-at-windham-prison/#respondSat, 24 Feb 2018 02:25:54 +0000https://www.pressherald.com/2018/02/23/as-overdose-deaths-soar-lepage-says-hes-adding-treatment-beds-at-windham-prison/Maine Gov. Paul LePage said Friday that he’s adding a “significant” number of substance abuse treatment beds at the Maine Correctional Center in Windham – a statement that baffled and upset some Democratic lawmakers.

LePage, a Republican, also promised to continue to address the opioid crisis “on all fronts,” after the Maine Attorney General’s Office reported Thursday that 418 people died from overdoses in 2017 – an 11 percent increase over the 376 overdose deaths in 2016 and a continuation of the sharp climb in overdose deaths in the past five years.

“We are saddened to see an increase in overdose deaths due to opioids and we will continue to address this crisis on all fronts,” LePage said in a written statement. “We need more education, stronger enforcement and more available treatment, including faith-based programs.”

LePage also said, “We are adding hundreds of treatment beds in Windham with a significant portion dedicated to substance-abuse intervention.” The governor has blamed Democrats for blocking his efforts to expand drug treatment at the prison in the past.

In 2016, the Legislature approved a $150 million bond issue for a planned renovation and expansion of the state prison in Windham. At the time, the Maine Department of Corrections indicated that the project would expand inmate treatment for substance abuse, among other physical, behavioral and mental health issues.

Related

However, Democratic lawmakers said Friday they’ve seen no plan for the prison expansion that includes a detailed proposal to increase access to substance abuse treatment. The department’s website shows only a feasibility study and concept proposal for the project dating back to 2014, when the cost estimate for the expansion was $173 million.

“I don’t know what he’s talking about,” said Rep. Charlotte Warren, D-Hallowell, House chairwoman of the Criminal Justice and Public Safety Committee.

“There has been conversation about treatment beds, but he’s talking about incarcerating folks,” Warren said. “We’re talking about a public health crisis and again our chief executive turns to the criminal justice system. He’s pivoting away from the problem and he’s looking for someone to blame it on.”

Senate Democratic Leader Troy Jackson, D-Allagash, further questioned why such a significant part of the governor’s purported drug treatment strategy is linked to incarceration.

“We don’t need to wait for people to break a law before we start treating them,” Jackson said. “That shouldn’t be a priority. Let’s start treating people right now.”

In his statement, the governor also highlighted the need to stop fentanyl from coming into Maine.

“The increasing availability of fentanyl is fueling an increase in overdoses,” LePage said. “Fentanyl-related deaths surged 27 percent in 2017. When heroin users are led to believe they are taking their usual amount of heroin, but it is fentanyl, they overdose. We must stop the trafficking of fentanyl into our state.”

LePage noted that the Maine Bureau of Insurance released data last month showing a 21 percent decrease in prescriptions for opiates or opioid derivatives among people covered by insurance, from 51,253 in the first half of 2016 to 40,591 in the first half of 2017.

“We must also focus prevention efforts on our middle-school youth so that they never start using any addictive substance that can lead them down this tragic path,” LePage said.

LePage closed his statement by taking Attorney General Janet Mills to task for issuing Thursday’s overdose data with a newspaper opinion piece she wrote about the opioid crisis that didn’t say she’s a Democratic candidate for governor.

Kelley Bouchard can be contacted at 791-6328 or at:

kbouchard@pressherald.com

Twitter: KelleyBouchard

]]>https://www.pressherald.com/2018/02/23/as-overdose-deaths-soar-lepage-says-hes-adding-treatment-beds-at-windham-prison/feed/0https://multifiles.pressherald.com/uploads/sites/4/2014/02/windham+Prison.jpgFri, 23 Feb 2018 23:46:48 +0000Universal home care proposal gets enough signatures to appear on Maine ballothttps://www.pressherald.com/2018/02/23/universal-home-care-proposal-gets-enough-signatures-to-appear-on-maine-ballot/
https://www.pressherald.com/2018/02/23/universal-home-care-proposal-gets-enough-signatures-to-appear-on-maine-ballot/#respondFri, 23 Feb 2018 20:09:25 +0000https://www.pressherald.com/2018/02/23/universal-home-care-proposal-gets-enough-signatures-to-appear-on-maine-ballot/AUGUSTA — Supporters of a proposed tax on Maine high earners to pay for home care for elderly and disabled people collected enough signatures from voters to get the initiative on the November ballot if lawmakers don’t pass it first, Secretary of State Matt Dunlap said Friday.

The chance of lawmakers passing the proposal is unclear, however, with House Republicans and business groups already expressing strong opposition.

The proposal would increase taxes on high-earning Mainers to raise $310 million annually for so-called “universal home care” for the elderly and disabled.

If successful, Maine – the nation’s oldest state – could be among the first to pass universal home care.

Hawaii recently passed a law providing up to $70 a day worth of services for a caregiver who has a full-time job yet must assist a loved one who’s over age 60. The state of Washington is considering a law to increase payroll contributions to provide family caregivers with $100 a day for a year.

Maine People’s Alliance spokesman Mike Tipping has said there’s an appetite in Maine to make the wealthy contribute more as income inequality grows nationwide. The campaign has reported receiving a $350,000 boost from nonprofits linked to billionaire philanthropist George Soros.

Under the proposal, employers and employees would together face a new 3.8 percent tax on the portion of wages and income above the amount that’s subject to Social Security employment taxes. In-home care providers and other groups that receive funds from the universal home care program would have to spend at least 77 percent on “direct service worker costs,” according to the proposal.

Conservatives and business groups argue that the tax would be worse for small businesses than the voter-approved, 3 percent surtax for school funding that lawmakers ended up repealing last year.

“Here we go again with another proposal to slam small-business owners and self-employed people with even higher state taxes, making Maine one of the highest taxed states in the nation,” said David Clough, state director of the National Federation of Independent Business.

]]>https://www.pressherald.com/2018/02/23/universal-home-care-proposal-gets-enough-signatures-to-appear-on-maine-ballot/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/09/Elderly-hands.jpgFri, 23 Feb 2018 20:12:21 +0000Maine Medical Center, ambulance provider to pay $1.4 million to settle claims of improper Medicare billinghttps://www.pressherald.com/2018/02/23/maine-medical-center-ambulance-provider-pay-1-425-million-in-medicare-fraud-settlement/
https://www.pressherald.com/2018/02/23/maine-medical-center-ambulance-provider-pay-1-425-million-in-medicare-fraud-settlement/#respondFri, 23 Feb 2018 17:41:32 +0000https://www.pressherald.com/2018/02/23/maine-medical-center-ambulance-provider-pay-1-425-million-in-medicare-fraud-settlement/Maine Medical Center in Portland and the state’s largest ambulance provider have agreed to pay $1.4 million to the federal government to settle allegations that the ambulance provider submitted reimbursement claims for ambulance rides that were not medically necessary, a violation of the federal False Claims Act.

North East Mobile Health Services of Scarborough will pay $825,000 to resolve allegations that between 2007 and 2015, it improperly billed Medicare for transporting an unspecified number of patients who it claimed were “bed-confined” or who were otherwise medically required to be transported by ambulance, the office of U.S. Attorney Halsey B. Frank said Friday.

Maine Medical Center, which has contracted with North East since 2007 as its favored provider for medical transport services, agreed to pay $600,000 to resolve allegations that hospital personnel provided North East with paperwork containing incomplete or inaccurate information about the medical necessity of an ambulance ride, Frank’s office said.

That paperwork was then used by North East to bill Medicare, according to federal prosecutors.

Both groups cooperated with the investigation, and because of the settlement, neither admits wrongdoing, according to court records. Prosecutors did not specify in their complaint the number of ambulance rides that may have been affected. North East is also accused of keeping money that Medicare had overpaid to the company – an allegation it also denies. North East’s alleged improper conduct spanned from October 2007 to December 2017, according to a settlement agreement with Frank’s office. Maine Medical Center’s alleged improper conduct occurred between October 2007 and March 2015, the agreement said.

LESS COSTLY THAN A LAWSUIT

A call to Butch Russell, the CEO at North East, was not returned Friday, but the company released a statement through a public relations firm reasserting that North East did nothing wrong. The ambulance company also contended that all transports it provided were requested by medical professionals who were “acting in the best medical interest of the patient.”

Both groups said repaying the claims is less costly than defending a lawsuit.

“At the request of medical personnel, North East Mobile Health Services transported Maine Medical Center patients via ambulance to hospitals, skilled nursing facilities and other locations,” the North East statement said. “In all instances, all providers were acting in the best medical interest of the patient and the required documentation from medical personnel certified the ambulance transports were medically necessary. As such, reimbursement claims were submitted to Medicare and processed. However, the medical necessity of some of these ambulance transports was subsequently contested.”

Maine Medical Center, in a statement, also reiterated that it admitted no fault or liability, and called the settlement “an unfortunate result of a legal process that at times penalizes hospitals for prioritizing patient care,” and said the settlement heads off protracted and costly litigation.

The hospital said an “independent reviewer” found that Maine Medical Center saw no financial gain or incentive from the result of the disputed Medicare charges, but the statement did not identify the reviewer.

“Each case examined was based on medical necessity determined by a qualified medical provider,” the hospital said. “At all times, MMC acted with the best interests of patients in mind, making sure they had safe and reliable transportation following their treatment. We will continue to prioritize safe patient care and ensure that patients who have medical necessity receive access to ambulance services in a way that fully complies with legal and regulatory standards.”

The allegations by the government include details about the ambulance company’s relationship with the hospital. Since 2007, North East has held a “preferred provider” contract with Maine Medical Center to transport routine and critical care patients 24 hours a day, seven days a week. North East would often transport patients being discharged from the hospital to a skilled nursing facility or other rehabilitation center.

STAFFERS SIGNED OFF

For Medicare to pay a portion of the ambulance cost, the patient must be bed-confined or otherwise medically required to be transported by ambulance. Medicare will not cover the cost of an ambulance if a patient is able to walk around or sit in a wheelchair, meaning he or she could be transported by car or wheelchair van – modes of transport that Medicare does not pay for.

For North East to be reimbursed, the company is required to submit paperwork to Medicare showing that the ride was medically necessary. That documentation included a template certification form that North East provided and that hospital staff filled out.

Although North East’s own records showed that numerous patients could sit upright, move around and were not confined to a hospital bed or otherwise required to be transported by ambulance, the paperwork that Maine Medical staffers signed off on showed the ambulance ride as medically necessary, prosecutors alleged.

“These certifications are contradicted not only by the contemporaneous narratives of (North East Mobile Health Services) personnel, but also by (Maine Medical Center’s) medical records,” prosecutors alleged in a complaint.

According to Maine Medical Center’s settlement agreement, the hospital began conducting an internal audit in March 2015 of every nonemergency ambulance transport to ensure the information it submitted was accurate and complete.

As part of the agreement, Maine Medical Center agreed to continue conducting the self-audit for 18 months after the agreement was signed, until August 2019, and that it would notify North East of any suspected error in the paperwork within a reasonable time frame.

Although there is no specific number of allegedly improper ambulance rides, prosecutors allege that the vast majority of 949 patients who underwent total knee replacement surgery between 2010 and 2012 did not meet the requirements for ambulance rides, and could have been taken by car or wheelchair van.

LISTED AS ‘BED-CONFINED’

In one case from July 2010, a woman who had a knee replaced at Maine Medical Center was able to walk the roughly 10 feet from her hospital chair to a stretcher.

A Maine Medical Center nurse said the patient was fine to walk, but she was nonetheless transferred by stretcher to an ambulance that took her to St. Joseph’s Manor in Portland, according to prosecutors. The certification offered by Maine Medical Center for her transport showed she was “bed-confined,” according to prosecutors, and North East was paid $201.56 by Medicare on a $424 claim.

A week later, North East was dispatched to pick up the same woman to transport her to Maine Medical Center to have her other knee replaced. When EMTs arrived, the woman was sitting on the edge of her bed and denied having any pain or discomfort. She was able to walk with a walker to the ambulance stretcher and then to her hospital bed, prosecutors alleged.

The woman was listed again as “bed-confined” when North East billed Medicare for the $389 trip, of which it was paid $185.06.

But North East had indicated in the forms that the service was “medically indicated and necessary for the health of the patient,” prosecutors wrote.

Two years ago, the advisory group pulled its recommendation for FluMist vaccine after research found it wasn’t working against swine flu, the kind of flu that was making most people sick then. But the Advisory Committee of Immunization Practices voted 12-2 Wednesday to recommend the nasal spray as an option for next winter’s flu season.

An official from AstraZeneca, the company that makes FluMist, said the problem with the vaccine has been identified and corrected. But panel members noted there’s still not good proof that FluMist works well against the swine flu bug.

“This is not an easy decision. It’s always a challenge to make a decision with incomplete data,” said one panel member, Dr. Edward Belongia of the Wisconsin-based Marshfield Clinic Research Foundation.

The panel makes its recommendations to the Centers for Disease Control and Prevention, which usually accepts the advice and sends it along as guidance to doctors, hospitals and health insurers.

FluMist is the only spray-in-the-nose vaccine on the market. It was first licensed in 2003 and is approved for healthy people ages 2 to 49.

]]>https://www.pressherald.com/2018/02/21/kid-friendly-flu-nasal-spray-gets-federal-ok/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1336079_Flu_Vaccine_Nasal_Spray_795.jpgFluMist maker AstaZeneca says vaccine problems have been correctedWed, 21 Feb 2018 22:51:48 +0000Flu cases decline slightly in Maine for week ending Feb. 10, but number remains highhttps://www.pressherald.com/2018/02/14/flu-still-running-rampant-through-most-maine-counties/
https://www.pressherald.com/2018/02/14/flu-still-running-rampant-through-most-maine-counties/#respondWed, 14 Feb 2018 19:30:34 +0000https://www.pressherald.com/2018/02/14/flu-still-running-rampant-through-most-maine-counties/Influenza cases declined slightly last week, but the flu is still rampant in Maine, straining hospital emergency departments, keeping people from work and school and causing 43 flu-related deaths so far this season.

The Maine Center for Disease Control and Prevention on Wednesday reported 831 new cases for the week ending Feb. 10, down from 876 new cases the previous week, but still the second-highest week of the 2017-18 flu season, which runs from October through May.

“I’m cautiously optimistic we’ve hit the peak and cases could start going down, but I’m not convinced yet,” said Sara Robinson, a Maine state epidemiologist. “There’s still a lot of flu out there. Stay home if you’re sick.”

Flu is notoriously unpredictable, and three weeks ago cases appeared to have plateaued at about 500 per week, but new cases jumped to 876 the week of Feb. 3.

The total number of reported flu cases for the season is now 4,147, and unless cases decline substantially, Maine could top the 2016-17 season total of 5,830 confirmed cases. The actual number of flu cases is much higher because many people recover at home and are not tested for influenza.

Flu is prevalent across the United States and was still increasing in the week of Feb. 3, the latest nationwide data available, according to the U.S. Centers for Disease Control and Prevention. There were 124,316 reported flu cases nationwide.

Dr. Anne Schuchat, acting director of the federal CDC, told reporters in a conference call on Feb. 9 that this year’s flu season is “particularly challenging” and may rival the H1N1 epidemic in 2009.

“We may be on track to break some recent records,” Schuchat said.

Maine’s more populated counties have been hit hardest. York County has reported 955 cases, followed by Cumberland County with 629 and Penobscot County at 580.

This year’s predominant strain of influenza A, H3N2, is a virulent strain that’s resulting in more hospitalizations and deaths, according to the federal CDC. In Maine, 20 percent of all reported flu cases in 2017-18 have resulted in hospitalization, compared to 14 percent last season.

There have been 43 flu-related deaths so far this flu season, but no pediatric deaths, and 842 hospitalizations. There were 71 flue-related deaths in the 2016-17 season.

“The influenza season is still raging,” Bankole said. “It’s not letting up yet.”

Bankole said the city has taken a number of steps this year to try to lessen the impact of the flu, including February flu clinics, putting hand sanitizers in all city buildings, hanging posters in all city bathrooms advising how to prevent the flu and recommending a quarantine for homeless people staying at the city’s shelter while they are recovering from the flu.

While H3N2 is the predominant strain, influenza B is starting to show up more, accounting for about 10 percent of all tests in Maine and 20 percent nationwide. For most of the flu season, H3N2 had accounted for about 95 percent of all influenza cases in Maine and about 90 percent nationwide. Influenza B is typically a less severe strain and not as likely to require hospitalization.

The flu shot’s effectiveness for this season has still not been determined, but for those who get a flu shot and still contract influenza, symptoms tend to be milder and not last as long, research has shown. The vaccine is never 100 percent effective because the flu virus is always mutating. In order to get the vaccine on the market in time, scientists must predict months in advance the predominant strains of flu that will be circulating. The vaccine was 48 percent effective in 2016-17 and 59 percent effective in 2015-16, according to the federal CDC.

Jenson Steel, a former patient at Portland’s HIV Positive Health Clinic, filed a complaint last week with federal regulators about possible violations of patient privacy laws when the city shared HIV patients’ names with researchers. He also asked the city to suspend the research until regulators issue a ruling. Staff photo by Ben McCanna

A former patient at a city-run health clinic has formally asked federal regulators to determine whether Portland officials violated privacy laws by sharing the names and contact information of more than 200 HIV-positive patients with university researchers without patient consent.

Jenson Steel, a former patient at the city’s HIV Positive Health Clinic and member of the Patient Advocacy Committee, said he filed a complaint last Thursday with the U.S. Department of Health and Human Services’ Office of Civil Rights. He and other members of the committee have asked the city to halt the research until the office issues a ruling.

“We decided that until we have a ruling on any (privacy) violations that everything should just stay frozen,” Steel said.

Only 30 of the 229 patients responded to a survey that researchers circulated using the contact information provided by the city. City Hall Communications Director Jessica Grondin said city officials are respecting the request of the Patient Advocacy Committee to put the analysis of the survey responses on hold.

“We are working with the Patient Advocacy Committee on the next steps, but for now, even though we did not violate patient privacy, there is no further action being taken on the survey at this time,” she said.

The federal complaint comes after the Maine Attorney General’s Office concluded that the city complied with the state’s HIV confidentiality statute, because the disclosure was for the limited purpose of research and approved by the University of Southern Maine’s Institutional Review Board. However, the Attorney General’s Office, which reviewed the process at Steel’s request, does not have the authority to rule on potential violations of the federal Health Insurance Portability and Accountability Act, and concerned patients were referred to the federal DHHS Office of Civil Rights.

“With respect to federal statutes, it was determined the disclosures were likely subject to the HIPAA Privacy Rule,” Melissa O’Neil, the AG’s executive assistant, said in a Feb. 5 email.

An official with the Office for Civil Rights said in an email that the agency does not comment on current or potential investigations.

CITY WON’T RELEASE STAFF RECORDS

A public records request filed by the Portland Press Herald in December produced little insight into the rationale behind the city’s decision to move forward with transferring the information to USM, despite being warned of potential privacy concerns.

The Press Herald requested all communications sent or received by city officials and USM researchers regarding the survey, and the list of employees involved in the process. The city has so far withheld those records, effectively citing confidentiality of personnel information.

“To the extent that any records exist that contain complaints of misconduct or information that may lead to discipline, those documents are confidential and not subject to disclosure,” Grondin said in a written response. “The city does not have a non-confidential document listing the names of city employees involved in coordinating the survey with USM. Further, the findings of the city’s investigation of complaints relating to the survey are privileged and confidential.”

The Press Herald is continuing to seek city communications about the survey.

Julie Sullivan, a senior adviser to the city manager, had been overseeing the survey, but Steel said she was taken off the project and the Patient Advocacy Committee is now working with Dawn Stiles, director of the city’s Health and Human Services Department.

Grondin said in an email that no employee has been disciplined as a result of the patient information disclosure.

The list of patients and their contact information was provided to researchers at USM’s Muskie School of Public Service, who were asked to survey former patients about whether they have been able to receive care for a variety of medical needs – including STD testing, primary health care, specialized HIV care and psychiatric care – that were once available under one roof at the city’s India Street Public Health Center.

The clinic closed in 2017 after a federal grant that funded the program was transferred to Greater Portland Health, a nonprofit, federally qualified health center in Portland. A city analysis showed that only 33 patients followed the funding to Greater Portland Health.

Some former patients and former medical providers at the clinic were outraged when protected health information was disclosed without patient permission. They were concerned that the act of providing names to researchers would reveal their sensitive medical conditions.

CONFLICTING CLAIMS ON NOTICE TO PATIENTS

One of the health care officials, Dr. Ann Lemire, former medical director at the India Street clinic, has said she warned the city in September that it should not be sharing the list of patients with a third party, because doing so would violate federal patient privacy laws.

The survey, which USM mailed to patients in November, reopened old wounds for many patients, who had developed strong relationships with staff at the city program and pleaded with city councilors over the course of several public hearings not to shutter the clinic, which was doing nationally recognized work.

The city claims the Patient Advocacy Committee was informed that the city intended to share the patient names and contact information with USM, which would deliver the survey results to the city in a way that did not identify patients. However, committee members disputed that claim, saying that they were assured by Sullivan, the adviser to the city manager, that the city would be contacting the patients.

“It is a travesty that these same patients were again mistreated by the city of Portland,” said Joey Brunelle, who advocated for saving the city clinic where his former partner was a patient. “This could have been prevented – warnings were ignored. The city had a moral and legal responsibility to protect these patients and their sensitive information, and it failed them. There ought to be consequences when something like this happens.”

CITY ADMITS A ‘TECHNICAL DEFICIENCY’

City officials have emphasized that they did not need to get patient consent, because state and federal laws allow such disclosures for research purposes. They also stress that no “breach” has occurred.

However, the federal Health Insurance Portability and Accountability Act requires a formal business associate agreement to be in place before protected health information is shared with researchers.

After the city apologized for not communicating better with patients about the impending survey, Grondin admitted that the city did not have a fully executed business associate agreement with USM when the patient information was shared. She described it as “technical deficiency.”

“Although USM’s researchers’ original written assurance that they would protect such information did not include all of the language required in a HIPAA business associate agreement, the city and USM promptly corrected that technical deficiency by executing a fully HIPAA-compliant business associate agreement,” Grondin said in a written statement Dec. 12.

Randy Billings can be contacted at 791-6346 or at:

rbillings@pressherald.com

Twitter: randybillings

]]>https://www.pressherald.com/2018/02/14/federal-office-asked-to-rule-on-whether-city-violated-patient-privacy-laws/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1331673_256159-20170119_HIV_0049-e1518577087228.jpgJenson Steel, a former patient at Portland's HIV Positive Health Clinic, filed a complaint last week with federal regulators on possible violations of patient privacy laws when the city shared HIV patient names with researchers. He also asked the city to suspend the research until regulators issue a ruling.Tue, 13 Feb 2018 23:49:28 +0000OxyContin maker to cut back marketinghttps://www.pressherald.com/2018/02/10/oxycontin-maker-to-cut-back-marketing/
https://www.pressherald.com/2018/02/10/oxycontin-maker-to-cut-back-marketing/#respondSat, 10 Feb 2018 22:52:51 +0000https://www.pressherald.com/2018/02/10/oxycontin-maker-to-cut-back-marketing/NEW YORK — The maker of the powerful painkiller OxyContin says it will stop marketing opioid drugs to doctors, bowing to a key demand of lawsuits that blame the company for helping trigger the current drug abuse epidemic.

OxyContin has long been the world’s top-selling opioid painkiller, bringing in billions in sales for privately held Purdue, which also sells a newer and longer-lasting opioid drug called Hysingla.

The company announced its surprise reversal Saturday. Purdue’s statement said it eliminated more than half its sales staff last week and will no longer send sales representatives to doctors’ offices to discuss opioid drugs. Its remaining sales staff of about 200 will focus on other medications.

The OxyContin pill, a time-release version of oxycodone, was hailed as a breakthrough treatment for chronic pain when it was approved in late 1995. It worked over 12 hours to maintain a steady level of oxycodone in patients suffering from a wide range of pain ailments. But some users quickly discovered they could get a heroin-like high by crushing the pills and snorting or injecting the entire dose at once. In 2010 Purdue reformulated OxyContin to make it harder to crush and stopped selling the original form of the drug.

Purdue eventually acknowledged that its promotions exaggerated the drug’s safety and minimized the risks of addiction. After federal investigations, the company and three executives pleaded guilty in 2007 and agreed to pay more than $600 million for misleading the public about the risks of OxyContin. But the drug continued to rack up blockbuster sales.

Dr. Andrew Kolodny, director of opioid policy research at Brandeis University and an advocate for stronger regulation of opioid drug companies, said Purdue’s decision is helpful, but that to make a real difference, other opioid drug companies have to do the same.

“It is difficult to promote more cautious prescribing to the medical community because opioid manufacturers promote opioid use,” he said.

Two other companies that sell the medications, Johnson & Johnson and Allergan, did not immediately respond to requests for comment.

Kolodny said that opioids are useful for cancer patients who are suffering from severe pain, and for people who only need a pain medication for a few days.

But he said the companies have promoted them as a treatment for chronic pain, where they are more harmful and less helpful, because it’s more profitable.

“They are still doing this abroad,” Kolodny said. “They are following the same playbook that they used in the United States.”

]]>https://www.pressherald.com/2018/02/10/oxycontin-maker-to-cut-back-marketing/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1330202_Purdue_Pharma_Opioids_8372.jpgFILE - This Feb. 19, 2013 file photo shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. The maker of the powerful painkiller said it will stop marketing opioid drugs to doctors, a surprise reversal after lawsuits blaming the company for helping trigger the current drug abuse epidemic. OxyContin has long been the world's top-selling opioid painkiller and generated billions in sales for privately-held Purdue. (AP PhotoSat, 10 Feb 2018 17:59:33 +0000U.S. flu season continues to get worsehttps://www.pressherald.com/2018/02/09/u-s-flu-season-continues-to-get-worse/
https://www.pressherald.com/2018/02/09/u-s-flu-season-continues-to-get-worse/#respondSat, 10 Feb 2018 00:56:59 +0000https://www.pressherald.com/2018/02/09/u-s-flu-season-continues-to-get-worse/NEW YORK — The flu has further tightened its grip on the U.S. This season is now as bad as the swine flu epidemic nine years ago.

A government report out Friday shows 1 of every 13 visits to the doctor last week was for fever, cough and other symptoms of the flu. That ties the highest level seen in the U.S. during the swine flu in 2009.

And it surpasses every winter flu season since 2003, when the government changed the way it measures flu.

“I wish that there were better news this week, but almost everything we’re looking at is bad news,” said Dr. Anne Schuchat, acting director of the Centers for Disease Control and Prevention.

Flu season usually takes off in late December and peaks around February. This season started early and was widespread in many states by December. Early last month, it hit what seemed like peak levels – but then continued to surge.

The season has been driven by a nasty type of flu that tends to put more people in the hospital and cause more deaths than other more common flu bugs. Still, its long-lasting intensity has surprised experts, who are still sorting out why it’s been so bad. One possibility is that the vaccine is doing an unusually poor job; U.S. data on effectiveness is expected next week.

Some doctors say this is the worst flu season they’ve seen in decades. Some patients are saying that, too.

Veda Albertson, a 70-year-old retiree in Tampa, was sick for three weeks with high fever and fluid in her lungs. She said she hadn’t been this sick from the flu since the 1960s, when she was a young mother who couldn’t get out of bed to go to the crib of her crying baby.

“It was like ‘Wham!’ It was bad. It was awful,” she said of the illness that hit her on Christmas Day.

Heather Jossi, a 40-year-old Denver police officer and avid runner, said her illness last month was the worst flu she’s experienced.

“I don’t remember aches this bad. Not for four days,” Jossi said. “It took me out.”

Albertson said she got a flu shot, but Jossi did not.

Last week, 43 states had high patient traffic for the flu, up from 42, the CDC reported. Flu remained widespread in every state except Hawaii and Oregon and hospitalizations continued to climb.

“It’s beginning to feel like a marathon,” said Dr. Anthony Marchetti, emergency department medical director at Upson Regional Medical Center, a 115-bed hospital in rural Georgia. A quarter of the hospital’s emergency department visits are patients with flu, and the hospital has added nursing staff and placed beds in halls to accommodate the increase, he said.

“It just means we have to keep on keeping on. We’re getting used to it,” Marchetti said.

So far, it has not been a remarkably bad year for flu deaths. Flu and flu-related pneumonia deaths have lagged a little behind some recent bad seasons. The CDC counts flu deaths in children and there have been 63 so far. They have gone as high as about 170 in a season. Overall, there are estimated to be as many as 56,000 deaths linked to the flu during a bad year.

But reports of deaths – some in otherwise healthy children and young adults – have caused growing fear and concern, health officials acknowledge.

On Friday, Delisah Revell brought her 10-month-old daughter to the Upson Regional emergency room. “I heard how bad it is and I didn’t want to take any chances,” said Revell, who drove 30 minutes to get to the hospital in Thomaston.

The CDC said the amount of suspected flu cases at doctor’s offices and hospital emergency rooms last week matched that seen in 2009, when a new swine flu pandemic swept the world.

Swine flu, also called pandemic H1N1, was a new strain that hadn’t been seen before. It first hit that spring, at the tail end of the winter season, but doctor visits hit their height in late October during a second wave.

This flu season, hospitalization rates have surpassed the nasty season of the winter of 2014-2015, when the vaccine was a poor match to the main bug.

Health officials have said this year’s vaccine targets the flu viruses that are currently making people sick, including the swine flu virus that has become a regular winter threat. However, preliminary studies out of Australia and Canada have found the shot was only 10 to 20 percent effective in those countries against the H3N2 strain that’s causing the most suffering this winter.

]]>https://www.pressherald.com/2018/02/09/u-s-flu-season-continues-to-get-worse/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1329909_Flu_Season_66615.jpg-738b0.jpgKilian Daugherty, 1, is prepped for a chest X-ray by radiology technologist Kerah Adams while he's examined for flu symptoms at Upson Regional Medical Center in Thomaston, Ga., on Friday, as the flu further tightens its grip on the U.S.Fri, 09 Feb 2018 19:56:59 +0000Maine woman tells Congress about high cost of treating arthritishttps://www.pressherald.com/2018/02/08/maine-woman-tells-congress-about-high-cost-of-treating-arthritis/
https://www.pressherald.com/2018/02/08/maine-woman-tells-congress-about-high-cost-of-treating-arthritis/#respondThu, 08 Feb 2018 19:14:59 +0000https://www.pressherald.com/2018/02/08/maine-woman-tells-congress-about-high-cost-of-treating-arthritis/A Maine woman who suffers from rheumatoid arthritis has told a senate committee that the high cost of treating the disease is an unfair burden on thousands of patients.

Eighty-year-old Patty Bernard of Falmouth testified before the Senate Aging Committee on Wednesday at the request of Republican Sen. Susan Collins, R-Maine.

Bernard told the committee she was able to manage the symptoms of rheumatoid arthritis with medication until she retired at age 79 and switched from employer-sponsored insurance to Medicare.

Bernard says the cost of the drug shot from a copayment of $10-$30 to $3,800 per month.

Rheumatoid arthritis is an autoimmune disorder that affects the joints. Collins says it affects more than a million Americans, including more than 8,700 people in Maine.

The Journal Tribune reported that Nathan Howell will replace retiring CEO Ed McGeachey on May 21.

The new CEO will be oversee York County’s largest health care system and one of the county’s largest employers. The system includes a full service, acute-care medical center in Biddeford and a medical center in Sanford.

Howell graduated from Colby College and earned his business degree from Cornell University.

He previously served as president and CEO of North Star Health Alliance and Claxton-Hepburn Medical Center in Ogdensburg, N.Y.

]]>https://www.pressherald.com/2018/02/07/southern-maine-health-care-names-new-ceo/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/11/1282977_732551-20171103_SMHC1570.jpgSouthern Maine Health Care in Biddeford amassed $15.5 million in uncompensated care in fiscal year 2016.Wed, 07 Feb 2018 23:29:36 +0000Instead of peaking, flu cases in Maine jump 63% from previous weekhttps://www.pressherald.com/2018/02/07/flu-season-in-maine-reaching-peak-with-876-new-cases-reported-last-week/
https://www.pressherald.com/2018/02/07/flu-season-in-maine-reaching-peak-with-876-new-cases-reported-last-week/#respondWed, 07 Feb 2018 16:23:34 +0000https://www.pressherald.com/2018/02/07/flu-season-in-maine-reaching-peak-with-876-new-cases-reported-last-week/Last week saw a dramatic rise in the number of new flu cases and hospitalizations in Maine, adding to what already has been one of the worst years in nearly a decade.

There were 876 new cases of influenza, a 63 percent increase over the previous week, as well as 120 new hospitalizations and five deaths attributed to the flu.

The Maine Center for Disease Control and Prevention released the new data Wednesday, bringing the totals for this season to 3,047 cases, 667 hospitalizations and 34 deaths. Flu season begins in October and runs through May.

Sara Robinson, an epidemiologist with the Maine CDC, said experts had hoped flu cases were peaking late last month, but that doesn’t appear to be the case.

“It’s a little bit hard to tell because every flu season is different,” she said. “We know this year’s flu season started a little earlier. We’d certainly like to see that curve turn around, but it’s not happening yet.”

Robinson said this season is one of the worst in recent memory but has not reached the pandemic levels that Maine and other states saw in 2009.

“I think the biggest message is: It’s not too late to get vaccinated. Even if it’s not a perfect match, it’s still going to protect you,” she said. “The other thing is: If you’re sick, stay home. You’re not doing anyone any favors by going into work.”

YORK COUNTY AMONG HARDEST HIT

The number of new cases documented last week represented a sharp increase over the previous two weeks, when 538 and 531 cases were reported, respectively.

This season’s numbers also are much higher than last year’s at this time.

As of Feb. 4 last year, there were just 669 cases of the flu and 109 hospitalizations. This year, there are 740 cases and 114 hospitalizations in York County alone.

For the entire 2016-17 flu season, there were 5,830 reported cases, 1,151 hospitalizations and 71 deaths in Maine.

Dr. Dora Anne Mills, former head of the Maine CDC and now vice president of clinical affairs at the University of New England, said this season has indeed been a bad one.

“The most predictable thing about influenza is its unpredictability,” she said.

Mills also encouraged people to get flu shots if they haven’t already. She also said Tamiflu, available through a prescription, can cut down on the length and severity of the flu.

Mills said it’s hard to tell whether Maine has reached peak flu season or whether cases are still on the rise. She said other states have been hit harder over the past few weeks, so maybe Maine is just now catching up.

Comparing this year’s flu to past years is difficult, too, she said, because it has only been for the past 10 years or so that the state has been keeping detailed and up-to-date data.

The flu strain circulating in Maine this year is still predominantly A H3N2, one of the most virulent strains, especially for seniors. The virus has taken a toll on nursing homes and assisted living facilities and recently has led to overcrowded emergency rooms.

CONFIRMED CASES IN U.S.: 83,000

Of the 21 documented flu outbreaks last week, 19 were in long-term care facilities. An outbreak occurs when three or more cases are reported in a single location.

The federal Centers for Disease Control and Prevention has reported widespread flu cases in every state except Hawaii. Nationally, there were about 83,000 confirmed cases of influenza through last week.

The actual number of flu cases is much higher than those reported because many people recover at home and are never tested. Symptoms include fever, chills, muscle aches, swollen lymph nodes, sore throat, headaches, fatigue and coughing.

Health experts also have said that the number of deaths related to the flu may have been underrepresented because many individuals die of secondary infections that are attributable to influenza. However, influenza is not always listed as a cause on a death certificate.

Even though it’s now deep into flu season, people can still get a flu shot, although shots are not foolproof. According to the federal CDC, the vaccine was 48 percent effective in 2016-17 and 59 percent effective in 2015-16.

However, health professionals say those who get the flu despite receiving a flu shot typically have milder symptoms.

Frequent hand-washing and avoiding contact with those who may have the flu are recommended.

]]>https://www.pressherald.com/2018/02/07/flu-season-in-maine-reaching-peak-with-876-new-cases-reported-last-week/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1326374_Flu_Season_Worsens_33952.jp_.jpgDr. Doug Olson visits a patient at Northside Hospital in Cumming, Ga., on Monday. Flu hospitalizations are high this season, the government reports.Thu, 08 Feb 2018 10:36:15 +0000Flu cases lead to surge in patients at Portland emergency roomshttps://www.pressherald.com/2018/02/05/surge-in-patients-at-portland-emergency-rooms-attributed-to-flu-cases/
https://www.pressherald.com/2018/02/05/surge-in-patients-at-portland-emergency-rooms-attributed-to-flu-cases/#respondTue, 06 Feb 2018 02:15:32 +0000https://www.pressherald.com/2018/02/05/surge-in-patients-at-portland-emergency-rooms-attributed-to-flu-cases/Emergency rooms at Portland’s two largest hospitals were crammed with patients Monday, a surge that hospital officials attributed to the state’s influenza outbreak.

By late Monday, there were more than 115 people seeking treatment at Maine Medical Center’s emergency department – a number that was above average, said Dr. Mike Baumann, Chief of MMC’s Emergency Medicine.

“We peaked at 116,” Baumann said, adding that the ER normally has an average of 80 patients. A lot of people suffering flu-like symptoms come to the ER for treatment, but many are sent home to recover.

At one point Monday, the hospital was boarding 24 patients in the emergency department while they waited for hospital beds to become available.

“The flu has definitely been a contributing factor,” Baumann said, noting that the number of patients awaiting beds had dropped to 17 by late Monday night.

Baumann said the outbreak has strained the hospital’s resources. Since the flu is considered an infectious disease, a patient can’t be placed in the same room with someone who is at risk of becoming infected.

“It’s already a tight situation with patient beds, but when you add the flu season to that, it makes a tight situation all that more difficult,” said Clay Holtzman, Maine Med’s director of communications and public affairs.

Most of the patient rooms at MMC have double beds, which is one of the reasons why the hospital hopes to break ground next spring on a $512 million expansion that will add 128 single-occupancy patient rooms. Holtzman said single-occupancy rooms will help the hospital cope with future infectious disease outbreaks like the one they are now seeing.

“It has been a severe flu season and I think that is what we are experiencing now,” Holtzman said.

Mercy Hospital’s emergency department, which is located on State Street, also was straining Monday to keep up with an influx of sick patients, many of whom were seeking treatment for influenza-like symptoms.

Dr. John Southall, director of Mercy’s Emergency Medical Department, said Mercy’s ER was filled with patients.

He said most of the patients he observed were “really sick,” adding that “we have more people waiting than we like to see.”

“It’s very busy. All the emergency department rooms are full and we have patients waiting,” Southall said. He was unable to say how many of those patients were suffering from the flu, but said it’s likely that the flu was contributing to the surge in activity.

Emily Spencer, a spokeswoman for the Maine Center for Disease Control and Prevention, wasn’t able to provide an update on the number of flu cases in the state so far in the 2017-2018 season, but the state’s most recent influenza surveillance report available online said there had been 2, 307 confirmed cases and 28 influenza deaths in Maine as of Jan. 27.

The flu strain circulating in Maine is still predominantly A H3N2, one of the most virulent strains, especially for seniors.

Flu season runs from October through May, and nationally, the federal Centers for Disease Control and Prevention has reported widespread flu cases in every state except Hawaii.

Nationally, there were 65,735 confirmed cases of influenza through Jan. 13 – the most recent national data available, according to the CDC. On Friday, the CDC reported that a total of 53 children have died of the flu this season.

Both Maine Medical Center and Mercy Hospital encourage people who are not feeling well to check first with their primary care physician before going to a hospital emergency room. They also encourage sick people to go to urgent care centers to avoid the long wait they may encounter at a hospital ER.

Southall said that an urgent care center can often treat a person’s illness, while an emergency room is better equipped to intervene in more severe cases, such as when a patient is dehydrated and needs intravenous fluids.

“Patients in the emergency room are going to be seen in order of acuity, not when they arrive,” Southall said. That means a person seriously hurt in a motor vehicle crash will be seen before someone seeking treatment for the flu.

Southall said Maine saw an early start to the flu season before it tapered off. Now it has returned, he said.

“It’s just ebb and flow,” Southall said, adding that Maine’s flu season should taper off in March or April.

The government’s report out Friday showed the flu season continued to intensify last week.

One of every 14 visits to doctors and clinics were for fever, cough and other symptoms of the flu. That’s the highest level since the swine flu pandemic in 2009. Last week, 42 states reported high patient traffic for the flu, up from 39.

Experts had thought this season might be bad, but its intensity has surprised most everyone.

“It’s been the busiest I can remember for a long time,” said Dr. Doug Olson, an ER doctor at Northside Hospital Forsyth, in Cumming, Georgia. Another hospital in the Atlanta area this week set up a mobile ER outside to handle flu cases.

The heavy flu season has also put a strain some medical supplies, including IV bags, and flu medicine.

The Centers for Disease Control and Prevention tally shows hospitalization rates surged to surpass the nasty season of the winter of 2014-2015, when the vaccine was a poor match to the main bug. So far, however, deaths this season from the flu and flu-related pneumonia have lagged a little behind some recent bad seasons. There are as many as 56,000 deaths connected to the flu during a bad year.

The flu usually peaks in February. This season had an early start, and health officials initially thought it would also have an early peak. But so far it hasn’t worked out that way.

“There may be many weeks left for this season,” said the CDC’s Dr. Dan Jernigan.

Illnesses seem to be easing a bit on the West Coast. Oregon joined Hawaii last week as the only states where flu wasn’t widespread. Friday’s report covers the week ending Jan. 27.

In the U.S., annual flu shots are recommended for everyone age 6 months or older. This season’s vaccine targets the strains that are making Americans sick, including the key H3N2 virus. How well it worked won’t be known until later this month. An early report from Canada for the same flu shot shows protection against that bug has been poor, just 17 percent.

Canada’s flu season so far has been milder with more of a mix of strains. But CDC officials said effectiveness figures in the U.S. may end up in the same range.

]]>https://www.pressherald.com/2018/02/02/flu-season-continues-to-intensify-across-nation/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/02/1326374_Flu_Season_Worsens_33952.jp_.jpgDr. Doug Olson visits a patient at Northside Hospital in Cumming, Ga., on Monday. Flu hospitalizations are high this season, the government reports.Fri, 02 Feb 2018 20:04:29 +0000Bills to increase Maine’s accountability for intellectually disabled get strong supporthttps://www.pressherald.com/2018/01/31/bills-to-increase-states-accountability-for-oversight-of-intellectually-disabled-mainers-get-strong-support/
https://www.pressherald.com/2018/01/31/bills-to-increase-states-accountability-for-oversight-of-intellectually-disabled-mainers-get-strong-support/#respondWed, 31 Jan 2018 23:57:43 +0000https://www.pressherald.com/2018/01/31/bills-to-increase-states-accountability-for-oversight-of-intellectually-disabled-mainers-get-strong-support/Parents and caretakers said Wednesday they strongly support two bills to increase the accountability and transparency of the Department of Health and Human Services’ role in overseeing care for people with intellectual disabilities and autism.

“I would feel better,” Darla Stimpson Chafin told the Legislature’s Health and Human Services Committee at a public hearing for L.D. 1676.

“Parents of adults in the system want to know that these people we love will be treated with the same respect and basic safety that we all expect in our lives,” said Chafin, whose 50-year-old daughter is autistic.

The bill would create an independent panel to review deaths and serious injuries, and would also require DHHS to hire a full-time registered nurse to review reports and work with the panel, and make annual reports to the committee.

The bills come in the wake of a scathing federal report released last fall that found the department neglected to investigate 133 deaths and did not properly report critical incidents including sexual assault, suicidal acts and serious injuries over a 2½-year period.

“The report was very troubling, but even more alarming was the silence that followed. The fact that there was no oversight body to catch this failure is almost unbelievable,” said bill author Rep. Dale Denno, D-Cumberland.

A second bill, L.D. 1709, seeks to bolster the role of an existing but anemic oversight board – the Maine Developmental Services Oversight and Advisory Board.

Terri Earley said a review of deaths by an independent panel might have helped her get answers about her healthy, 21-year-old autistic son, who died of a seizure six months after moving into a group home. He was discovered in the morning, not by overnight caretakers who were supposed to check on him every 20 minutes and listen all the time.

“We really were left with lots of questions,” Earley told the committee: Were the employees awake? Was the baby monitor on? “These are answers we’ll never know.”

An independent panel might “give them a slap on the wrist” – and send a message to other caretakers to closely monitor clients.

“I don’t want to penalize a home where there aren’t enough homes. But I don’t want his death to be in vain either,” she said. “It deserved to have some attention.”

DHHS is making changes in response to the audit, officials say, and on Wednesday a representative noted that the department is now investigating all deaths of clients, and creating new protocols for meeting and communicating with providers.

L.D. 1709, the bill to bolster the oversight and advisory board, would allow the board to “complete the task they were created to carry out,” said bill sponsor Rep. Jennifer Parker, D-South Berwick.

The board and supporters meet monthly, but DHHS stopped sending it data years ago, even though the department is required by statute to provide the information, members told the committee. The 15-member board has only five or six official members because names put forward for appointment never get vetted or approved by the department and governor’s office, according to the board’s executive director.

“The board’s ability to provide independent oversight has been almost entirely stymied by the board’s inability to receive any statistics or data from (DHHS) regarding the very population the (board) was designed to protect,” said Executive Director Nonny Soifer. “This has been very frustrating and also quite frightening. We know that the health and safety of Maine adults with intellectual disabilities or autism has been severely compromised, yet the (board) has not been informed of incidents of abuse, neglect or death.”

Amy MacMillan, acting director of the Office of Aging and Disability Services in DHHS, said the department opposes L.D. 1709. She said DHHS stopped sending the board information in 2016 after a breach in confidentiality, and referred questions about the failure to appoint members to the governor’s office.

DHHS is supposed to provide the board information on, among other things, injuries and deaths, crisis services, quality assurance and budgets. The board, in turn, is supposed to “provide independent oversight” and focus on systemic concerns around health and safety, and delivery of services, and to report annually to the governor and Legislature.

“If I didn’t want a board to exist, I’d make it nonfunctional,” Rep. Patty Hymanson, D-York, said to MacMillan. “Another way I’d do that is to not give it information at all.”

“Does the department often choose to follow or not to follow a law?” she asked MacMillan.

One parent nominated to the board two years ago says she attends the meetings even though she never heard from the governor’s office about her appointment.

“But more importantly than a formal appointment, I want to point out how disappointing and disheartening it has been to sit together, month after month, with the other (board members), with nothing to review, no data to examine, no reports to read, nothing,” said Kim Humphrey, whose 28-year-old autistic son lives in a group home. “We are unable to do what the law has set forth for us as a protection for people like my son.”

]]>https://www.pressherald.com/2018/01/31/bills-to-increase-states-accountability-for-oversight-of-intellectually-disabled-mainers-get-strong-support/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/09/1251470_405816-DHHS1.jpgThe Maine DHHS says it already had taken steps to address some of the issues raised in a highly critical federal audit.Wed, 31 Jan 2018 20:10:45 +0000FDA seeks to curb abuse of common anti-diarrhea drugshttps://www.pressherald.com/2018/01/30/fda-seeks-to-curb-abuse-of-common-anti-diarrhea-drugs/
https://www.pressherald.com/2018/01/30/fda-seeks-to-curb-abuse-of-common-anti-diarrhea-drugs/#respondTue, 30 Jan 2018 17:05:44 +0000https://www.pressherald.com/2018/01/30/fda-seeks-to-curb-abuse-of-common-anti-diarrhea-drugs/WASHINGTON — U.S. health regulators want makers of popular anti-diarrhea drugs to sell their tablets in smaller amounts to make them harder to abuse.

The request comes amid a spike in overdoses from large doses of the over-the-counter drugs, which contain a small amount of an opioid.

The Food and Drug Administration said Tuesday it is asking manufacturers to package their medications in smaller quantities, such as eight tablets per package. Currently, some generic versions are sold in boxes of up to 200 tablets.

The key ingredient in anti-diarrhea medications like Imodium is part of the opioid family, an addictive drug class that includes morphine and oxycodone. At low doses, the medicine helps control diarrhea. But recent statistics show a rise in abuse of massive doses to try and get high.

]]>https://www.pressherald.com/2018/01/30/fda-seeks-to-curb-abuse-of-common-anti-diarrhea-drugs/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/label.jpgTue, 30 Jan 2018 12:27:51 +0000100 years later: 1918 flu epidemic still eclipses all othershttps://www.pressherald.com/2018/01/27/100-years-later-1918-flu-epidemic-still-eclipses-all-others/
https://www.pressherald.com/2018/01/27/100-years-later-1918-flu-epidemic-still-eclipses-all-others/#respondSat, 27 Jan 2018 23:13:34 +0000https://www.pressherald.com/2018/01/27/100-years-later-1918-flu-epidemic-still-eclipses-all-others/The flu arrived as a great war raged in Europe, a conflict that would leave about 20 million people dead over four years.

In 1918, the flu would kill more than twice that number – and perhaps five times as many – in just 15 months. Though mostly forgotten, it has been called “the greatest medical holocaust in history.”

Experts believe between 50 million and 100 million people were killed. More than two-thirds of them died in a single 10-week period in the autumn of 1918.

Never have so many died so swiftly from a single disease. In the United States alone, it killed about 675,000 in about a year – the same number who have died of AIDS in nearly 40 years.

As the country muddles through a particularly nasty flu season, the 1918 nightmare serves as a reminder. If a virulent enough strain were to emerge again, a century of modern medicine might not save millions from dying.

“You think about how bad it was in 1918, and you think surely our modern medical technology will save us, but influenza is the Hollywood movie writer’s worst nightmare,” said Anne Schuchat, the Centers for Disease Control’s deputy director, at a recent seminar on the 1918 pandemic. “We have many more tools than we had before, but they are imperfect tools.”

SPANISH FLU STRIKES

One hundred years ago, a third of the world’s population came down with what was dubbed the Spanish flu. It got its name when the king of Spain, Alfonso XIII, his prime minister and several cabinet ministers came down with the disease.

The flu brought life to a standstill, emptying city streets, closing churches, pool halls, saloons and theaters. Coffin makers couldn’t keep up with demand, so mass graves were dug to bury the dead. People cowered behind closed doors for fear they would be struck down.

In Philadelphia, news stories described priests driving carts through the streets, encouraging people to bring out the dead so that they might be buried.

In New York, there were accounts of people feeling perfectly healthy when they boarded the subway in Coney Island and being taken off dead when they reached Columbus Circle.

Entire families succumbed. In Tyler County, West Virginia, John Linza, his wife and two of their sons died on the same day. Two other sons died just days before them. The last Linza, an infant, died the day after his parents.

In the southwestern tip of Virginia, J.W. Trent, his wife and two sons fell ill. They were preceded in death by all four of their young daughters – Hattie, Mary, Ellen and Ruby.

SPREADS WORLDWIDE

In 10 weeks, the flu killed 20,000 in New York City and produced 31,000 orphans.

There is debate among historians about where the flu first surfaced – did it come from China or a British encampment in northern France or rural Kansas? But it spread worldwide practically overnight.

By the end of November, 50,000 had died in South Africa, where at its peak flu killed 600 people each day. In Egypt, the death count reached 41,000 in Cairo and Alexandria by January. In Tahiti, trucks roamed the streets of Papeete to collect the dead, and great funeral pyres burned day and night to incinerate the bodies.

Normally the most vulnerable to influenza are infants, whose immune systems are not yet up to the test, and the elderly, whose ability to fight disease diminishes with age. But in 1918, more than half the people it killed were in the prime of their lives.

Many died within hours, turning blue from lack of oxygen as they coughed up foamy blood from their lungs and bled from the nose, ears and eyes.

The Spanish flu infected the upper respiratory tract and then dove deep into the lungs with viral or bacterial pneumonia. How did it kill so many young healthy adults? Their immune systems attacked the influenza invader with such force that it killed them.

One Army doctor, quoted by historian John M. Barry, author of the bestseller, “The Great Influenza,” described the scene at a base hospital in Massachusetts:

“When brought to the (hospital) they very rapidly develop the most vicious type of pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see (the blueness) extending from their ears and spreading all over the face. … It is only a matter of a few hours then until death comes. … It is horrible.”

Yet President Woodrow Wilson was unwilling to take any action that would compromise the war effort.

In early October, even as the disease was sweeping through military bases, killing soldiers and sailors by the thousands, U.S. Surgeon General Rupert Blue warned against rushing to see doctors with “mild cases of influenza.”

Then as now, the catch phrase was “a touch of the flu.” The flu rolled in every winter, enveloping people in a fog and fever that lasted a few days and lingered for a week or two. It was something to be endured, but not many people died from it. And so it began in 1918.

To comprehend what came next requires an understanding of the disease. The world’s most successful vaccinations against measles, polio, tetanus and smallpox generally work in the same way. They introduce a minuscule amount of the disease so that if it ever arrives in full-blown form, the body will recognize and neutralize it with an immune system counterattack.

Influenza, however, never gives the immune system a stable target. Instead, it can transform itself into something that appears innocent to the white blood cells and enzymes intended to wage war against it.

That explains why a vaccine against the flu is a hit-or-miss proposition, based on the best guess of scientists about what flu strains are most likely to emerge six months later. This year the CDC estimates flu vacines will be 30 percent effective against infection.

MUTATES INTO A KILLER

In 1918, there were no flu vaccinations, and it would not have mattered anyway. After the “touch of the flu” that proved deadly only here and there during the spring, the influenza apparently mutated into a killer.

By early autumn the public face of America and the Western world had a gauze mask on it. People wore them to church, the military marched in them, police posed for photos in them and doctors wore them to visit patients. In Seattle, anyone who tried to board streetcars without a gauze mask was arrested.

But the fine spray of a sneeze creates a cloud of more than half a million virus particles, and the virus can live for hours on any hard surface where they settle.

Four women who gathered to play bridge in Albuquerque, New Mexico, in November prudently wore six-ply cloth masks. Three of them were dead the next day.

The frightening spread of the disease led to official and self-imposed quarantines.

Schools, theaters, bars and other gathering places were ordered closed. Mothers were told their children should be confined to their own yards. In New York, officials so feared transmission on overcrowded subways that they ordered people to work staggered shifts.

People cowered from contact with anyone who might carry the disease. A doctor in Philadelphia spoke of driving from the hospital to his suburban home without seeing another person or vehicle on the streets.

Many flu victims died in their homes of starvation, and not the disease, because they were too weak to seek food and no one dared bring it to them.

]]>https://www.pressherald.com/2018/01/27/100-years-later-1918-flu-epidemic-still-eclipses-all-others/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1323340_AP_051008027438.jpgInfluenza victims crowd an emergency hospital near Fort Riley, Kan., in 1918. The 1918 Spanish flu pandemic killed at least 50 million people worldwide and officials say that if the next pandemic resemblers it, 1.9 million Americans could die.Sat, 27 Jan 2018 19:08:59 +00002018 flu outbreak on track to be worst in nearly a decadehttps://www.pressherald.com/2018/01/27/2018-flu-outbreak-on-track-to-be-worst-in-nearly-a-decade/
https://www.pressherald.com/2018/01/27/2018-flu-outbreak-on-track-to-be-worst-in-nearly-a-decade/#respondSat, 27 Jan 2018 22:43:30 +0000https://www.pressherald.com/2018/01/27/2018-flu-outbreak-on-track-to-be-worst-in-nearly-a-decade/With tens of thousands of patients flocking to hospitals and at least 37 children dead, this year’s flu season is shaping up to be the worst in nearly a decade – and it’s not over yet.

At a time when experts hoped new cases would start tapering off, federal health officials said Friday that the number of patients seeking care for flulike symptoms continues to rise sharply.

Nearly 12,000 people have been hospitalized with confirmed cases of flu, an increase of 3,000 in just one week, according to the Centers for Disease Control and Prevention. The latest report, for the week ending Jan. 20, shows the rate of people seeking care now rivals that of the swine-flu pandemic of 2009.

In Florida, West Boca Medical Center in Boca Raton has seen a surge of patients. “We think it may be peaking,” said Adam Leisy, head of the emergency room, “but who knows what the next few weeks will bring.”

Leisy said his hospital has been flooded with elderly snowbirds – often already dealing with chronic conditions and now wheezing from coughs and struggling with fever.

In California, some hospitals have pitched tents outside their ERs to cope with the crush of patients; some facilities there have flown in nurses from out of state. Doctors have worked double and triple shifts. In Chicago, a shortage of patient beds has left ambulances idling outside hospitals.

In New York, state leaders last week issued an emergency order allowing pharmacists to give vaccines to children.

The toll on children has been especially severe. CDC officials said the pediatric death count is likely to approach, if not exceed, the 148 deaths reported during the especially severe flu season of 2014 and 2015. That season ended with 56,000 flu-related deaths, 710,000 people hospitalized and 16 million who sought care from a clinician or hospital.

This year’s intensity has been driven by a particularly nasty strain of the virus known as H3N2. Another strain has also begun showing up, hitting baby boomers especially hard, CDC officials said Friday, although experts have not figured out exactly why.

The CDC says the number of pediatric deaths is probably more than the 37 reported, because if often takes longer for deaths outside hospitals to be reported to authorities. The real number may be twice as high, officials said.

“You hear people talking about how serious it can get, but you never think it’s going to happen to you,” Anne LaMontagne, 41, said as she sat by her son in a Minneapolis hospital.

The flu blanketed the U.S. again last week for the third straight week. Only Hawaii has been spared.

Last week, 1 in 15 doctor visits were for symptoms of the flu. That’s the highest level since the swine flu pandemic in 2009. The government doesn’t track every flu case but comes up with estimates; one measure is how many people seek medical care for fever, cough, aches and other flu symptoms.

Flu is widespread in every state except Hawaii, with 39 states reporting high traffic to doctors last week, up from 32.

At this rate, by the end of the season somewhere around 34 million Americans will have gotten sick from the flu, the Centers for Disease Control and Prevention said Friday.

Some good news: Hospital stays and deaths from the flu among the elderly so far haven’t been as high as in some other recent flu seasons. However, hospitalization rates for people 50 to 64 – baby boomers, mostly – has been unusually high, CDC officials said in the report, which covers the week ending Jan. 20.

A New York pediatrician said her office has been busy but the kids with the flu haven’t been quite as sick as in the past.

This year’s flu shot targets the strains that are making Americans sick, mostly the H3N2 flu virus. But exactly how well it is working won’t be known until next month. It’s the same main bug from last winter, when the flu season wasn’t so bad. It’s not clear why this season is worse, some experts said.

“That’s the kicker. This virus really doesn’t look that different from what we saw last year,” said Richard Webby, a flu researcher at St. Jude Children’s Research Hospital in Memphis.

It may be that many of the people getting sick this year managed to avoid infection last year. Or there may be some change in the virus that hasn’t been detected yet, said the CDC’s Dr. Dan Jernigan, in a call with reporters Friday.

Based on patterns from past seasons, it’s likely the flu season will start to wane soon, experts say.

The season usually peaks in February, but this season started early and took off in December.

Flu is a contagious respiratory illness. It can cause a miserable but relatively mild illness in many people, but more a more severe illness in others. Young children and the elderly are at greatest risk from flu and its complications. In a bad season, there are as many as 56,000 deaths connected to the flu.

In the U.S., annual flu shots are recommended for everyone age 6 months or older. Last season, about 47 percent of Americans got vaccinated, according to CDC figures.

]]>https://www.pressherald.com/2018/01/26/flu-rages-on-for-third-straight-week/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1323041_Flu_Season_35946.jpg-1eb3f.jpgExperts recommend getting a flu shot, but say it isn't yet clear how effective the vaccine is this season. Center, gives a patient a flu shot in Seattle. Flu season continues to get worse, as this has become the most intense the country has seen since a pandemic strain hit nine years ago, U.S. health officials said on Friday, Jan. 26, 2018. (AP PhotoFri, 26 Jan 2018 20:47:56 +0000Mary Dempsey leaving Maine cancer center she helped foundhttps://www.pressherald.com/2018/01/26/mary-dempsey-leaving-maine-cancer-center-to-teach-laughter-yoga/
https://www.pressherald.com/2018/01/26/mary-dempsey-leaving-maine-cancer-center-to-teach-laughter-yoga/#respondFri, 26 Jan 2018 17:55:41 +0000https://www.pressherald.com/2018/01/26/mary-dempsey-leaving-maine-cancer-center-to-teach-laughter-yoga/LEWISTON — Mary Dempsey, sister of actor Patrick Dempsey, has left the cancer center she helped found.

Dempsey left last month, just before the center formally separated from Central Maine Healthcare to become its own nonprofit. She had been serving as community services coordinator.

Dempsey said Thursday that when the center was about to become independent, she “paused to reflect.”

“I had an opportunity to make a decision in my future,” she said.

She decided that future would mean stepping away from the Dempsey Center and toward a new passion.

“You can’t create an incredible place like the Dempsey Center without wanting it to continue to excel and do well,” she said. “It will always be in my heart and soul.”

On Friday, she said leaving her beloved center has been a “grieving process.”

Patrick Dempsey released a statement through the center Thursday.

“The Dempsey Center is here to serve the community, both locally and statewide, and that truly takes a team effort — the work we do is bigger than me, or any member of my family,” he said. “We need to honor the (c)enter’s history, which Mary is a big part of, and we thank her for her 10 years of service.”

Founded in 2008, the Dempsey Center — then called The Patrick Dempsey Center for Cancer Hope & Healing — was created in partnership with Central Maine Medical Center in Lewiston to help cancer patients and their families. Patrick Dempsey and his siblings, who grew up in Buckfield, helped found the center in honor of their mother.

Amanda Dempsey was diagnosed with ovarian cancer in 1997, and battled the disease for 17 years. She died in 2014 at age 79.

The center provides free cancer support, education and complimentary therapies, such as massage, regardless of where patients and families live and regardless of where patients receive treatment.

As of last summer, the Dempsey Center had an annual budget of about $2.2 million, employed 20 people and served more than 4,000 people a year.

In July, center leaders announced the Dempsey Center would leave the Central Maine hospital system to become its own nonprofit. It also planned to merge with Cancer Community Center, a 19-year-old South Portland nonprofit that also provides free support to cancer patients and their families.

The Dempsey Center officially became independent on Jan. 1, 2018. Tardif said the merger will be finalized in the coming months.

The center is now hiring a client services specialist to replace Dempsey.

Although her brother has been the celebrity face of the center, Dempsey was more often its voice. She regularly welcomed new people to the center, worked with volunteers and attended fundraisers.

In 2012, Massachusetts General Hospital’s Cancer Center honored her as one of 100 people advancing the fight against cancer. In 2014, she testified at a U.S. Senate hearing on cancer research. In 2015, Saint Joseph’s College in Standish presented her with an honorary doctor of public service degree.

Dempsey worked at Central Maine Medical Center for almost 30 years before helping to found the Dempsey Center at the hospital. She left the hospital system as well as the center.

Dempsey is now looking for another career in which she can support the community.

In the meantime, she also plans to focus some attention on another passion: Laughter Yoga.

She became interested in Laughter Yoga — which combines movement and laughter — while on a trip to Italy to speak about the Dempsey Center. Intrigued, she traveled to India in November to train with Madan Kataria, founder of Laughter Yoga.

She is now a certified Laughter Yoga instructor.

Dempsey plans to start her Laughter Yoga work with veterans. She does not plan to leave the area.

“This is my home,” she said.

Wendy Tardif, executive director of the Dempsey Center, said Mary Dempsey will remain part of the committee that reviews applications for the center’s annual Amanda Dempsey Award, and is expected to stay involved with the survivor walk held every year during Dempsey Challenge, the center’s largest fundraiser.

Patrick Dempsey maintains his seat on the center’s board.

“I’m excited about the work we’re doing, our shared vision for the future and the tremendous support this community has for the (c)enter and one another,” he said in his statement. “I remain as positive and committed as ever to this community’s wellness and prosperity.”

The state Department of Health and Human Services finalized the rules last year and is scheduled to implement them on Feb. 1, but the Legislature’s Health and Human Services Committee wants to put those rules on hold while it considers new legislation that may nullify some or all of them. On Thursday, the committee voted 12-0 in favor of a bill that would delay implementation until July, which is when bills drafted this session would go into effect.

The full Legislature could vote on the medical rules moratorium bill as early as Tuesday, but even if it sailed through both houses, it would still require approval from Gov. Paul LePage before it goes into effect. LePage’s approval is far from guaranteed, and it could take him as long as 10 days to decide whether he would sign it or not. If he vetoes it, which some committee members believe he will, the override attempt would eat up more time.

Related

That means it is highly unlikely that the fate of the moratorium bill will be known before the new medical rules go into effect on Feb. 1. Committee members such as Rep. Deborah Sanderson, R-Chelsea, asked DHHS Commissioner Ricker Hamilton to delay implementation until the moratorium bill can go to a full vote in the Legislature, or until the committee develops its own legislative reforms, but Hamilton has yet to reply.

“We are looking at a situation where the rules will be in effect before we get the moratorium in place,” said Sen. Eric Brakey, R-Auburn, the committee’s Senate chairman.

Some of the owners of the labs that test and do the extraction work for Maine’s caregiver community – the state’s eight licensed medical marijuana dispensaries test and perform extractions in house now – have told caregivers they plan to shut down when the new rules go into effect to avoid possible regulatory penalties or referrals to law enforcement. No Maine lab owner was willing to discuss their business plans Thursday, but several confirmed closure plans off the record.

With that in mind, the committee voted Thursday to skip the public hearing on a moratorium to minimize the potential disruption to Maine’s medical marijuana industry. It didn’t sit well with Rep. Patricia Hymanson, D-York, the committee’s House chairman. She said it wasn’t fair to erase DHHS rules without giving the agency the “dignity” of explaining its reasoning at a hearing.

“I don’t want to step on their toes,” Hymanson said. “They deserve to tell us. We deserve to hear their message before we rewrite rules they’ve already thought about.”

Both DHHS’s Hamilton and LePage believe the medical marijuana program is flawed. On Jan. 12, Hamilton sent a letter to the committee saying it lacks enough oversight, administrative authority and resources, and that bills pending before the committee only begin to “scratch the surface of needed reform.” LePage cited the unchecked growth of the caregiver network when he vetoed the adult-use marijuana bill last year.

Penelope Overton can be contacted at 791-6463 or at:

poverton@pressherald.com

Twitter: PLOvertonPPH

]]>https://www.pressherald.com/2018/01/25/panel-votes-to-put-new-medical-pot-rules-on-hold-until-july/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1312596_Legalized_Pot_Medical_78494.jpgJars of medical marijuana are on display on the counter of a marijuana dispensary in Los Angeles. All but four states allow some form of medical marijuana.Fri, 26 Jan 2018 10:04:48 +0000Analysis: Canada takes novel approach with prescription opioid vending machineshttps://www.pressherald.com/2018/01/24/analysis-canada-takes-novel-approach-with-prescription-opioid-vending-machines/
https://www.pressherald.com/2018/01/24/analysis-canada-takes-novel-approach-with-prescription-opioid-vending-machines/#respondWed, 24 Jan 2018 20:35:33 +0000https://www.pressherald.com/2018/01/24/analysis-canada-takes-novel-approach-with-prescription-opioid-vending-machines/Among their many differences, Canada and the United States share a common crisis: opioid overdoses.

Drug overdoses are the leading cause of accidental death in the United States, killing more people than the AIDS epidemic at its peak. More than 42,000 Americans died of opioid-related causes in 2016, and the crisis shows no signs of receding.

Canada, too, is in the grip of an opioid overdose epidemic, but public health officials in the province of British Columbia – which is projected to account for nearly one-third of overdose deaths in the country in 2017 – are hoping to prevent a surge in deaths with a novel approach: a vending machine that distributes prescription opioids to addicts.

The B.C. Center for Disease Control (BCCDC) announced last month that it plans to install three vending machines this spring that will dispense hydromorphone pills, a powerful prescription opioid, to people with a high risk of overdose. A landmark study in 2016 found the painkiller to be an effective opioid replacement therapy, and experts say it could also reduce dependencies on contaminated street drugs cut with lethal substances such as fentanyl.

A $1 million grant from Health Canada will help to fund the project, which officials say could be expanded as early as this summer after its launch in the spring.

“This is an emergency crisis situation,” said Mark Tyndall, the executive medical director of the BCCDC and a backer of the project. “We don’t have the luxury of pilot testing these things on a few people over the next year.”

At least 1,460 people died of an opioid-related overdose in Canada in the first half of 2017, a figure that Canada’s public health agency projects will surpass 4,000 once data is reported for the rest of the year. British Columbia declared a public health emergency in 2016. More than 1,208 people died of opioid overdoses from January to October 2017, according to the B.C. Coroners Service.

Fentanyl, a synthetic opioid that is up to 100 times more powerful than morphine, was detected in 83 percent of overdose deaths in British Columbia. It is increasingly being used to cut street drugs such as cocaine and heroin – sometimes surreptitiously – dramatically boosting their potency, with often deadly consequences.

Death rates from drug overdoses in British Columbia are almost as high as those in the states hardest-hit by the opioid epidemic in the United States. In British Columbia, the drug overdose death rate was 30.2 deaths per 100,000 people from January to October 2017. In Delaware and Rhode Island, it was 30.8 per 100,000 people in 2016, according to the Centers for Disease Control and Prevention.

The severity of the crisis in British Columbia has pushed it to go further than the rest of the country in finding ways to reduce the harm done by drugs. The province is home to eight supervised injection sites, where addicts ingest illegal drugs under the supervision of nurses who can intervene in case of an overdose.

Since 2011, Vancouver’s Crosstown Clinic has offered injections of pharmaceutical-grade heroin to addicts for whom other therapies have been ineffective, and it recently began administering injectable hydromorphone for opioid addicts. But while these programs have been effective, officials say that their models are costly, difficult to scale and limited in their accessibility, particularly for those in remote communities.

The vending machine project could solve those problems. Under the pilot project, drug users would be able to get two to three hydromorphone pills three times a day. Each tablet costs roughly 3 Canadian dollars per day – far less than the 25,000 Canadian dollars per person per year that it costs for the programs at the Crosstown Clinic. The machines are relatively inexpensive, making it easy to expand the program quickly.

Vending machines have long been used as a harm-reduction tool. Syringe-dispensing vending machines have existed for decades in Puerto Rico, Europe and Australia to reduce the spread of HIV and hepatitis through injection drug use. Clark County, Nevada, and Ottawa, Ontario, started syringe-vending machine initiatives last year.

The vending machine project is not without its critics. A letter writer in a newspaper in Victoria, British Columbia, worried that hydromorphone would “be dispensed like candy.”

Vancouver police Sgt. Jason Robillard said that while there is a need for projects like this one that aim to mitigate the harm done by illegal drugs, he has concerns about “the safety and security of the people using the machines, and keeping the pills inside the machines secure.”

Tyndall said those concerns are unfounded. A company with experience designing vending machines for cannabis – which also requires extra security – has created prototypes of opioid-dispensing machines. The units would be linked in real-time to monitors and accessed using biometrics. The small quantity of pills dispensed and severity of the users’ addiction make it unlikely that they would sell their pills, he said. And if they did, the pills would be safer than toxic street drugs.

“I’m trying to get people out of the image of these as shopping mall-type vending machines that everyone can access,” Tyndall said. “These are really armored ATMs.”

Spokespeople for the syringe-dispensing machine projects in Clark County and Ottawa report no instances of theft or vandalism. Clark County is already expanding its program with two new machines this year.

Others have voiced concerns that the project’s focus on increasing the availability of clean drugs to addicts to counter the tainted street drug supply was misguided. Marilyn Gladu, a Conservative party lawmaker and the shadow minister for health, said efforts to deal with the crisis should center on preventing addiction and getting addicts into rehabilitation.

“We don’t think it’s a good idea to pay for drug addicts to keep taking drugs,” she said. “It’s not an elimination of the problem.”

The goal, Tyndall said, is to reduce the number of deaths from overdoses. “You cannot get someone into rehabilitation when they’re dead,” he said.

]]>https://www.pressherald.com/2018/01/24/analysis-canada-takes-novel-approach-with-prescription-opioid-vending-machines/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1321642_ap327926663237.jpgPublic health officials in the province of British Columbia are hoping to prevent a surge in deaths with a novel approach: a vending machine that distributes prescription opioids to addicts.Wed, 24 Jan 2018 16:07:03 +0000Influenza accelerating in Maine, with 531 new cases in the last weekhttps://www.pressherald.com/2018/01/24/influenza-cases-accelerating-in-maine/
https://www.pressherald.com/2018/01/24/influenza-cases-accelerating-in-maine/#respondWed, 24 Jan 2018 16:33:26 +0000https://www.pressherald.com/2018/01/24/influenza-cases-accelerating-in-maine/Reported flu cases continued to increase in Maine during the past week, but the number has yet to peak in a season that is already notable for its severity, health officials said.

The Maine Center for Disease Control and Prevention on Wednesday reported 531 new cases for the week ending Jan. 20, with 1,749 cases reported so far this flu season. The previous week there were 391 new cases.

Flu season runs from October through May, and nationally, the federal Centers for Disease Control and Prevention has reported widespread flu cases in every state except Hawaii. Nationally, there were 65,735 confirmed cases of influenza through Jan. 13, the most recent national data available, according to the U.S. CDC.

Maine has so far reported 22 deaths for which flu was at least a contributing factor, compared to 71 for all of 2016-17.

The flu strain is still predominantly influenza A H3N2, one of the most virulent strains, which more likely to require hospitalization, especially for seniors.

Maine reported 429 hospitalizations so far this season, and the mean age of those patients was 63. Twenty-five percent of all tested flu cases have resulted in hospitalization this season, compared to 14 percent in 2016-17.

Confirmed flu cases were most prevalent in York, Penobscot and Cumberland counties, with 394 cases in York, 257 in Penobscot and 253 in Cumberland County.

The actual number of flu cases is much higher than those reported because many people recover at home and are never tested. Symptoms include fever, chills, muscle aches, swollen lymph nodes, sore throat, headaches, fatigue and coughing.

There were 5,830 confirmed flu cases in Maine in 2016-17, although the predominant strain was less virulent, and there were fewer hospitalizations.

Places where people congregate – such as nursing homes, schools, universities and institutions, reported 52 outbreaks so far this season compared to 128 for all of the 2016-17 season. An outbreak is declared when three or more people at the same location report contracting the same infectious disease.

In nursing homes and assisted living facilities, which have a high percentage of immune system-compromised residents, the flu can spread quickly even though such facilities take precautions. Forty-six of the 52 outbreaks occurred in such facilities.

Richard Erb, president and CEO of the Maine Health Care Association, a trade group that represents nursing homes and assisted living facilities, said the facilities take standard precautions, such as encouraging flu shots for employees and patients, and encouraging visitors to come back on a different day if a flu outbreak is occurring. But he said there’s only so much that can be done.

Erb said he heard from a manager of a nursing home who didn’t want to be publicly identified that had 24 cases of the flu.

Health experts say people should still get vaccinated if they haven’t yet done so, even though flu-shot clinics are typically held in the fall. The flu shot is available at primary care practices, drug stores and through some employers.

It’s still not clear how effective the flu vaccine is this year. Every year, scientists attempt to predict the predominant flu strains that will be circulated, and the vaccine is never 100 percent effective.

The vaccine was 48 percent effective in 2016-17 and 59 percent effective in 2015-16, according to the CDC.

Research shows that people who obtain vaccinations can still contract the flu, but it will most likely be a milder version.

Though the Maine Board of Dental Practice determined last month that the longtime dentist had not violated professional standards of care in his treatment of five patients who filed complaints, the board is leaving the door open to hearing more cases.

The nine-member board recently declined to renew Kippax’s dental license, which expired Dec. 31. Instead, the board has opted to keep his existing license in effect until it makes a “final determination.”

Kippax, who has strongly denied mistreating patients, is allowed to continue his practice while the board weighs its options.

One patient whose complaint was not part of the hearing, Donna Deigan, said Tuesday that the board needs to keep trying.

She said, “He is abusive, and the board cannot continue to enable him and overlook the facts.”

Deigan said she “was in that chair” and “I know what he did to me.”

The case has raised questions about whether the public has been protected properly by Maine’s regulatory system.

At a session of the Legislature’s Labor, Commerce, Research and Economic Development Committee this month, Rep. Anne-Marie Mastraccio, D-Sanford, questioned if the dental-oversight system is adequate.

She told the dental board’s executive director, Penny Vaillancourt, “You know exactly what I’m referring to in terms of an oral surgeon who had so many complaints,” Maine Public reported recently.

Vaillancourt, however, said she is satisfied that the system works. She also mentioned that the case remains open.

It is not clear what the dental panel might try next, if anything. Its members were told by a hearing officer last month not to discuss the case because it might not be over.

Almost a year ago, the board suspended Kippax from practicing for a month, citing 195 allegations by 18 patients. The suspension lapsed in March, when the board failed to bring Kippax to a hearing within the statutory time limit.

By the time the board held a hearing, which began in September, assistant attorneys general who were handling the case had pared down the case to charges lodged by five patients who saw Kippax in 2015 and 2016.

By the end of December, after two expert witnesses testified that Kippax had done nothing wrong, the board ruled that the state had failed to prove its case on any of the charges.

It can, however, return to some of the other allegations raised by the 13 patients whose cases were not heard. There may also be complaints filed that never have been mentioned in public. For now, Kippax is free to work as a dentist in Maine. He also has licenses to practice in Vermont and Massachusetts.

scollins@sunjournal.com

]]>https://www.pressherald.com/2018/01/23/maine-dental-board-considers-whether-to-continue-case-against-lewiston-oral-surgeon/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/12/kippax-12-29-e1514593189375.jpgLewiston oral surgeon Jan Kippax at a hearing Friday to determine what, if any, sanctions it wants to impose on him for alleged violations of professional standards. The Maine Board of Dental Practice has been hearing the charges since September. (Steve Collins/Sun Journal)Tue, 23 Jan 2018 20:45:09 +0000Women now outnumber men in medical schoolshttps://www.pressherald.com/2018/01/22/women-medical-students-now-outnumber-men/
https://www.pressherald.com/2018/01/22/women-medical-students-now-outnumber-men/#respondMon, 22 Jan 2018 23:46:37 +0000https://www.pressherald.com/2018/01/22/women-medical-students-now-outnumber-men/Gifty Dominah cannot remember a time growing up that she did not think about becoming a doctor.

“When I was 5 years old, and my dad would ask me what I wanted to be, I would say, ‘A doctor,'” she said. “It was one of the only careers that I knew about, but I knew that I liked it.”

In August, the 24-year-old from Maryland entered the George Washington University School of Medicine in Washington.

Historically, medicine has attracted fewer women than men because of long working hours associated with the profession and the rigorous academic background required in advanced science and math –subjects that women have been less likely to pursue. Three decades ago, just over a third of medical students were women.

But this year, Dominah joined a class of medical students that for the first time is majority female nationwide, according to a new report by the Washington-based Association of American Medical Colleges. After making steady gains since the 1960s, women have hovered close to the 50 percent mark nationally for the past 15 years. The number of male applicants was slightly higher in 2017, but since 2015, male applicants declined while female applicants increased.

Many advocates of the profession credit the increasing number of women in medical schools to a growing emphasis on so-called pipeline programs that encourage girls to pursue math and science from the time they are in grade school.

Several medical schools around Washington long ago surpassed the 50 percent mark for women, and some have far surpassed it.

]]>https://www.pressherald.com/2018/01/22/women-medical-students-now-outnumber-men/feed/0https://multifiles.pressherald.com/uploads/sites/4/2015/03/597107_54919-20150131_hospice_3.jpgUniversity of New England medical students Kelly McVan, left, and Caitlyn Farrell take notes in the kitchen at the Gosnell Memorial Hospice House in Scarborough on Jan. 30.Mon, 22 Jan 2018 23:57:28 +0000Five Maine hospitals get top ratings for quality, safetyhttps://www.pressherald.com/2018/01/22/maine-med-gets-five-stars-for-quality-safety/
https://www.pressherald.com/2018/01/22/maine-med-gets-five-stars-for-quality-safety/#respondMon, 22 Jan 2018 16:02:42 +0000https://www.pressherald.com/2018/01/22/maine-med-gets-five-stars-for-quality-safety/Five Maine hospitals earned five-star ratings for quality and safety in the latest analysis by the U.S. Centers for Medicare & Medicaid Services.

Five out of five stars, the highest rating possible, was shared by only 337 of the 3,692 hospitals surveyed nationwide. In Maine, the hospitals that received the designation are: Maine Medical Center and Mercy Hospital in Portland, Maine Coast Memorial Hospital in Ellsworth, Northern Maine Medical Center in Fort Kent and Redington-Fairview General Hospital in Skowhegan, according to the Medicare.gov Hospital Compare website.

Maine Med is one of only 25 teaching hospitals in the U.S. to earn the five-star rating, the hospital said Monday in a statement. The star rating comprises 57 different measures of quality and safety in seven categories. The analysis by the federal government – known broadly as Hospital Compare – has become an important resource for patients, consumers and other quality rating systems such as the Leapfrog Group.

“Our patients and their families rely on us to provide the highest quality and safest care possible,” said Dr. Omar Hasan, senior vice president and chief quality and safety officer at Maine Med. “Everyone at Maine Medical Center takes great pride in going above and beyond that commitment in a thoughtful, compassionate and collaborative way.”

Maine has not adequately consulted with tribes about proposed work requirements that tribal leaders and advocacy groups say could cause Native Americans facing high unemployment rates to drop Medicaid and shift costs onto the underfunded Indian health system, said Penobscot Nation Chief Kirk Francis.

“Work requirements, and other barriers to health-care access, are counter to the execution of this trust responsibility and will not have their intended impact in Indian Country,” said Francis, who also serves as president of United South and Eastern Tribes Sovereignty Protection Fund.

The federal Centers for Medicare and Medicaid Services acknowledged such concerns in a letter Wednesday to tribal leaders. But the agency said exemptions for American Indians and Alaskan Natives could raise civil rights issues. It plans to hold a conference call with all tribes on Monday.

Jessica Steinberg, director of Indian health policy and research for the advocacy group National Indian Health Board, said policy found in court decisions, treaties and other documents could have long-term unintended consequences “due to the lack of understanding of the tribes and their special relationship to the government.”

The Trump administration announced this month that it will let states implement certain requirements, such as finding work as a condition of receiving Medicaid benefits. States are required to consult with tribes before imposing work requirements. The administration also said states “may wish” to provide exemptions for those who participate in tribal work programs.

In response to criticism from tribal leaders, Utah and Arizona already have changed their work requirement plans to protect Native Americans from losing Medicaid coverage.

Maine and Wisconsin, which both have federally recognized tribes, are not exempting Native Americans from proposed work and volunteer requirements, said Devin Delrow, director of policy for the National Indian Health Board and a member of the Navajo Nation.

Aroostook Band of Micmacs Chief Edward Peter-Paul said many residents in his rural, northern Maine community live with health problems, such as diabetes.

Emily Spencer, spokeswoman for the state Department of Health and Human Services, said any claim that Maine didn’t consult with tribes about the reform proposal is unfounded. She said tribal representatives haven’t asked about the issue during monthly conference calls with the department.

Republican Gov. Paul LePage, who went to Washington to lobby the Trump administration on his state’s proposed Medicaid reforms, has praised the Trump administration’s decision and said Maine’s plan is flexible and includes numerous exceptions.

“It takes away isolation,” LePage said on the Fox News Channel show “Your World with Neil Cavuto.”

“It creates new relationships. It improves the quality of life. It helps the labor force. And, most of all, it transitions them to a path to go towards commercial insurance and other forms of employer-sponsored insurance,” the governor said.

]]>https://www.pressherald.com/2018/01/19/maine-tribes-say-medicaid-work-requirement-would-jeopardize-health-care/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/03/1161703_972822-20170302_Judiciary7.jpgPenobscot Chief Kirk Francis says the state regularly tries to assert jurisdiction over tribal matters.Fri, 19 Jan 2018 21:15:09 +0000Maine reports 21 flu-related deaths so far this seasonhttps://www.pressherald.com/2018/01/19/maine-reports-21-flu-deaths-so-far-this-season/
https://www.pressherald.com/2018/01/19/maine-reports-21-flu-deaths-so-far-this-season/#respondFri, 19 Jan 2018 16:54:10 +0000http://www.pressherald.com/2018/01/19/maine-reports-21-flu-deaths-so-far-this-season/The number of flu-related deaths this season in Maine has reached 21, according to the Maine Center for Disease Control and Prevention.

Emily Spencer, a spokeswoman for the state agency, said the number includes people who have died from complications from flu.

“This is likely an underrepresentation because many individuals die of secondary infections that are attributable to influenza, but influenza might not be listed on the death certificate,” said Sara Robinson, an epidemiologist with the Maine CDC.

The number of deaths nearly doubled in the past week. There were 13 deaths at least partly attributable to influenza in Maine through Jan. 11, according to the Maine CDC. Maine reported 1,187 cases of people testing positive for flu through Jan. 13, and 391 of those cases were recorded in the latest seven-day period.

Spencer could not immediately provide comparison data to previous flu seasons in Maine as of Jan. 19, and cautioned that flu seasons do not begin and end at the same time. There were 71 deaths in Maine during the 2016-17 flu season, which started and ended later than usual.

Almost all of the cases this season in Maine have been H3N2, a virulent strain of influenza A that is more likely to result in hospitalization. By the end of last week, 327 flu cases in Maine required hospitalization, or about 28 percent of the positive flu tests reported to the state.

“This particular strain tends to affect older adults, which naturally leads to more hospitalizations and more deaths than a strain that affects a younger population,” Robinson said.

The spike in the number of flu cases has led to growing precautions around the state, including by churches that are suspending hand-touching and other traditional rituals that might spread the virus.

Across the nation, the U.S. Centers for Disease Control and Prevention reported 74,562 confirmed cases of the flu through testing, although actual numbers of people who fall ill from influenza are much higher, as many recover at home and are not tested for the flu. All states except Hawaii were reporting widespread flu activity in the latest U.S. CDC report, which measured flu activity through Jan. 13. Alabama’s governor issued a state emergency caused by flu outbreaks on Jan. 11, and other southern states, such as Florida and Georgia, are reporting that flu outbreaks are taxing hospital emergency departments, according to news reports.

Staff Writer Joe Lawlor contributed to this report.

]]>https://www.pressherald.com/2018/01/19/maine-reports-21-flu-deaths-so-far-this-season/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/AP18008682543663-1-e1515814475630.jpgSat, 20 Jan 2018 00:29:30 +0000Lyme cases in Maine spiked again in 2017 to another recordhttps://www.pressherald.com/2018/01/19/lyme-cases-in-maine-spiked-again-in-2017-to-another-record/
https://www.pressherald.com/2018/01/19/lyme-cases-in-maine-spiked-again-in-2017-to-another-record/#respondFri, 19 Jan 2018 09:00:00 +0000http://www.pressherald.com/?p=1318899Lyme disease and anaplasmosis soared to record highs in Maine last year, with experts saying the relatively warm fall probably contributed to the increase in tick-borne illnesses.

Except for a slight downturn in 2015, reported cases of Lyme disease have now broken records in Maine every year since 2011.

There were 1,787 positive tests for Lyme in 2017, a 22 percent increase over the 1,464 Lyme cases in 2016, according to statistics compiled by the Maine Center for Disease Control and Prevention. There were about 1,000 cases annually early this decade and a few hundred a year in the mid-2000s, Maine CDC data show.

Meanwhile, anaplasmosis cases jumped 78 percent in 2017, to 662 from 372 in 2016. Five years ago, there were fewer than 100 cases of infection annually from the anaplasmosis bacteria.

Lyme and anaplasmosis have similar flu-like symptoms, including fever, chills, headaches, fatigue and joint pain, but anaplasmosis symptoms tend to be more severe and are more likely to result in hospitalization.

TESTING TICK SURVIVABILITY

If caught early, both diseases can be treated effectively with antibiotics. Because many cases are not reported, the actual numbers of Lyme and anaplasmosis cases are much higher than the official reports from the government, health experts say.

Susan Elias, a disease ecologist at Maine Medical Center Research Institute, said it’s difficult to say what could have caused the increase in cases last year, but more awareness of tick-borne diseases by primary care physicians, better reporting of positive test results to the Maine CDC and a warm autumn could be reasons why 2017 was a banner year for Lyme disease.

“A warm fall might extend the questing season of nymphal and adult ticks,” Elias said of the period when ticks crawl up blades of grass or perch on the edges of leaves in a bid to latch onto a host. “Ticks are alive and well when temperatures are less than 50 degrees Fahrenheit, but they are much less active and less likely to find a host for a blood meal.”

Elias said that with a warm fall, people are also more likely to be outdoors and exposed to active deer ticks, which could contribute to the increasing numbers of Lyme cases.

“Anytime you compress the winter and the number of cold months, that’s good for the ticks,” Elias said.

The research institute is studying the effects of climate change on the range of the arachnid and how it could be contributing to the spread of Lyme disease. The center is in the third year of studying how ticks survive the winter, and this is the first winter with extended bitter-cold temperatures, which will be a good test of tick survivability, Elias said. Deer ticks have increased their range in Maine over the past 20-30 years, and are appearing much farther north, especially along the coast.

Elias said the jump in anaplasmosis cases could have been significantly affected by improved testing methods. She said several years ago when a patient was suspected of having Lyme disease, doctors sent away blood samples and only tested for Lyme. Now they send for a “tick panel” that routinely tests for Lyme, anaplasmosis, babesiosis and possibly other tick-borne diseases.

‘TICKS ARE EVER MORE PERVASIVE’

However, researchers are also finding that ticks are now more likely to carry both Lyme and anaplasmosis, especially in southern Maine.

Dr. Philip Baker, executive director of the Connecticut-based American Lyme Disease Foundation, said Mainers live “close to nature,” which may be one factor in the rise of tick-borne diseases.

“I don’t think it’s any one thing. It’s a combination of a number of things,” Baker said. “People are building homes in wooded areas. A bigger acorn crop could be a reason, because more acorns mean there’s more mice and other rodents for the ticks to attach to, which can spread Lyme disease.”

Angela Coulombe of Saco, a Lyme disease activist who contracted the disease several years ago, said that although it’s frustrating that cases are still climbing, the increase is leading to greater awareness of the problem, which means more resources may be devoted to the public health issue. People can do simple things to prevent themselves from contracting Lyme disease, such as doing frequent “tick checks,” having a buffer between wooded areas and homes, wearing proper clothing when going into the woods and putting on repellent.

“Ticks are ever more pervasive, and we are more likely to be exposed to them,” Coulombe said. “We have made huge leaps in awareness over the past 10 years, but there’s still so many physicians who aren’t aware of the proper treatments.”

Leading Democrats and LGBT groups immediately denounced the move, saying “conscience protections” could become a license to discriminate, particularly against gay and transgender people.

The announcement by the Department of Health and Human Services came a day ahead of the annual march on Washington by abortion opponents, who will be addressed via video link by President Trump. HHS put on a formal event in the department’s Great Hall, with Republican lawmakers and activists for conscience protections as invited speakers.

The religious and conscience division will be part of the HHS Office for Civil Rights, which enforces federal anti-discrimination and privacy laws. Officials said it will focus on upholding protections already part of federal law. Violations can result in a service provider losing government funding.

No new efforts to expand such protections were announced, but activists on both sides expect the administration will try to broaden them in the future.

Although the HHS civil rights office has traditionally received few complaints alleging conscience violations, HHS Acting Secretary Eric Hargan painted a picture of clinicians under government coercion to violate the dictates of conscience.

“For too long, too many health care practitioners have been bullied and discriminated against because of their religious beliefs and moral convictions, leading many of them to wonder what future they have in our medical system,” Hargan told the audience.

“The federal government and state governments have hounded religious hospitals and the men and women who staff them, forcing them to provide or refer for services that violate their consciences, when they only wish to serve according to their religious beliefs,” Hargan added.

After Hargan spoke, Rep. Kevin McCarthy, the No. 2 Republican in the House, provided an example of the kind of case the new office should tackle. McCarthy told the audience he has “high hopes” that the “arrogance” of a California law known as AB 775 “will be investigated and resolved quickly.”

That law, which requires anti-abortion crisis pregnancy centers to post information about abortion and other services, is the subject of a free-speech challenge brought by the pregnancy centers that will be heard by the U.S. Supreme Court.

Although the HHS civil rights office traditionally has gotten a small number of complaints involving religious and conscience rights, the number has grown since Trump was elected.

Office director Roger Severino said that from 2008 to November 2016, HHS received 10 such complaints. Since Trump won, the office has received 34 new complaints. Before his appointment to government service under Trump, Severino was an expert on religious freedom, marriage, and life issues at the conservative Heritage Foundation.

Democrats, LGBT organizations and some civil liberties groups were quick to condemn the administration’s action.

]]>https://www.pressherald.com/2018/01/18/new-federal-office-to-protect-doctors-conscience-rights/feed/0Thu, 18 Jan 2018 20:57:47 +0000Noninvasive blood test detects 8 types of cancerhttps://www.pressherald.com/2018/01/18/noninvasive-blood-test-detects-8-types-of-cancer/
https://www.pressherald.com/2018/01/18/noninvasive-blood-test-detects-8-types-of-cancer/#respondFri, 19 Jan 2018 01:10:56 +0000http://www.pressherald.com/2018/01/18/noninvasive-blood-test-detects-8-types-of-cancer/Scientists have developed a noninvasive blood test that can detect signs of eight types of cancer long before any symptoms of the disease arise.

The test, which can also help doctors determine where in a person’s body the cancer is located, is called CancerSEEK. Its genesis is described in a paper published Thursday in the journal Science.

The authors said the new work represents the first noninvasive blood test that can screen for a range of cancers all at once: cancer of the ovary, liver, stomach, pancreas, esophagus, colon, lung and breast.

Together, these eight forms of cancer are responsible for more than 60 percent of cancer deaths in the United States, the authors said.

In addition, five of them – ovarian, liver, stomach, pancreatic and esophageal cancers – currently have no screening tests.

“The goal is to look for as many cancer types as possible in one test, and to identify cancer as early as possible,” said Nickolas Papadopoulos, a professor of oncology and pathology at Johns Hopkins who led the work. “We know from the data that when you find cancer early, it is easier to kill it by surgery or chemotherapy.”

CancerSEEK, which builds on 30 years of research, relies on two signals that a person might be harboring cancer.

First, it looks for 16 telltale genetic mutations in bits of free-floating DNA that have been deposited in the bloodstream by cancerous cells. Because these are present in such trace amounts, they can be very hard to find, Papadopoulos said. For example, one blood sample might have thousands of pieces of DNA that come from normal cells, and just two or five pieces from cancerous cells.

To overcome this challenge, the team relied on recently developed digital technologies that allowed them to efficiently and cost-effectively sequence each individual piece of DNA one by one.

In addition, CancerSEEK screens for eight proteins that are frequently found in higher quantities in the blood samples of people who have cancer.

By measuring these two signals in tandem, CancerSEEK was able to detect cancer in 70 percent of blood samples pulled from 1,005 patients who had already been diagnosed with one of eight forms of the disease.

The test appeared to be more effective at finding some types of cancer than others, the authors noted. For example, it was able to spot ovarian cancer 98 percent of the time, but was successful at detecting breast cancer only 33 percent of the time.

The authors also report that CancerSEEK was better at detecting later stage cancer compared to cancer in earlier stages. It was able to spot the disease 78 percent of the time in people who had been diagnosed with stage III cancer, 73 percent of the time in people with stage II cancer and 43 percent of the time in people diagnosed with stage I cancer.

The plan, announced Thursday, follows years of shortages of generic injected medicines that are the workhorses of hospitals, along with some huge price increases for once-cheap generic drugs. Those problems drive up costs for hospitals, require significant staff time to find scarce drugs or devise alternatives, and sometimes mean patients get suboptimal medications.

The not-for-profit drug company initially will be backed by four hospital groups – Intermountain Health, Ascension and two Catholic health systems, Trinity Health and SSM Health – plus the VA health system.

Together, the five groups include more than 450 hospitals, nearly one-tenth of U.S. hospitals. They also run numerous clinics, nursing homes, doctors’ offices and other medical facilities, along with hospice and home care programs and an insurance plan. More health systems are expected to join soon.

The goal is to counter the consolidation of generic drugmakers that’s caused shortages for more than a decade and allowed some companies to raise prices many times over what some generics once cost. Those include antibiotics, morphine, heart drugs and others.

“It’s an ambitious plan,” Intermountain Healthcare CEO Dr. Marc Harrison said in a statement. He said health care systems “are in the best position to fix the problems in the generic drug market. We witness, on a daily basis, how shortages of essential generic medication or egregious cost increases for those same drugs affect our patients.”

Generic drugs can be manufactured very inexpensively, offering the hospital groups the chance to save hundreds of millions of dollars annually. The new company will either contract manufacturing to an existing company or get Food and Drug Administration approval to make medicines itself.

The company will be guided by an advisory board of high-profile experts from government, the pharmaceutical industry and Harvard Business School. Members include former Centers for Medicare and Medicaid Services administrator Dr. Don Berwick and Bob Kerrey, a pharmacist and former governor and senator from Nebraska.

Ascension, based in St. Louis, is the biggest U.S. non-profit health system, with 141 hospitals in 22 states. North-Dakota-based Trinity Health operates 93 hospitals in 22 states. St. Louis-based SSM Health runs 24 hospitals in four Midwestern states. Salt Lake City-based Intermountain has 22 hospitals in Utah and Idaho.

]]>https://www.pressherald.com/2018/01/18/hospitals-try-to-create-firm-for-cheaper-generic-drugs/feed/0https://multifiles.pressherald.com/uploads/sites/4/2014/12/554866_933327-20141212_OTJpetscr2.jpgAbove, Steve Hauke uses a mortar and pestle to grind a medication into powder for capsules. He spreads the powder into a capsule mold and then attaches a prescription label on the finished product.Thu, 18 Jan 2018 21:06:25 +0000First wave of Maine Med workers moves into downtown Westbrook officeshttps://www.pressherald.com/2018/01/18/influx-of-downtown-workers-begins-in-westbrook/
https://www.pressherald.com/2018/01/18/influx-of-downtown-workers-begins-in-westbrook/#respondThu, 18 Jan 2018 19:05:50 +0000http://www.pressherald.com/2018/01/18/influx-of-downtown-workers-begins-in-westbrook/WESTBROOK — Maine Medical Center employees began moving into One Riverfront Plaza this week, several months after the company purchased the long-vacant building.

The first wave of employees moved in Wednesday, according to the company. Up to 500 employees should be working in the building by mid-April.

The medical center purchased the downtown building, which overlooks the Presumpscot River, in June for $10.75 million. The office building, vacant since November 2015, will house Maine Med’s integrated Information Services employees along with other administrative functions currently spread across eight office locations throughout Greater Portland. MMC Communications Manager Caroline Cornish said the employees are moving into the building in phases so services aren’t disrupted.

City officials said they’re excited to have the MMC employees come to Westbrook and frequent the businesses along Main Street, accessible from the pedestrian bridge over the river.

“It’s going to put a significant population in the downtown on a daily basis,” said City Administrator Jerre Bryant. “It’ll be very good for the downtown economy.”

The city had been waiting for a large company to move into the building since insurer Disability RMS moved to South Portland in November 2015, taking 350 to 400 workers away from Westbrook. The promise of more employees coming to the building has done exactly what Bryant and others had hoped for by spurring economic interest in the downtown.

“We’ve received a lot of interest from folks, in part because of the Maine Med announcement,” Bryant said.

In the past year, a number of new businesses have located downtown or have announced plans to do so, including The Daily Grind, Quill Books and Beverage, Top Kabob and Legends Rest Taproom.

Bryant said the city has provided Maine Med with a list of downtown restaurants where they can get lunch, hold meetings or use for catering. Westbrook residents now also have more reason to visit downtown, he said.

“It increases the attraction for businesses to locate in the downtown, which also increases services for residents,” he said. “It’ll make the downtown more vibrant, which is a positive.”

The only potential drawback is increased traffic, but Bryant said he’s not concerned.

“We handled the population of Disability RMS for 10 years with no significant issues so I don’t anticipate any problems,” he said.

Offsetting the traffic increase at peak hours is the shift schedule of the Maine Med employees. Bryant said the shifts are spread out instead of all being 9 a.m. to 5 p.m. and all 500 employees won’t be driving at peak times.

The 134,000-square-foot building, which was built in 2004, was purchased by Maine Med from One Riverfront Plaza Holdings, LLC. The sale of the building to MMC also resulted in the medical center leasing the city-owned parking garage attached to the building.

The city has valued the building, on 0.85 acres, at $20.55 million, according to city tax records. Those records also show Pendleton Westbrook bought One Riverfront Plaza for $23.5 million in 2005.

The building went to auction in February 2017 after the U.S. National Bank Association filed a foreclosure notice. It was bought back by the bank for $9.2 million. The bank then accepted private bids for the purchase of the building.

Kate Gardner can be contacted at 781-3661 ext. 125 or at:

kgardner@theforecaster.net

Twitter: katevgardner

]]>https://www.pressherald.com/2018/01/18/influx-of-downtown-workers-begins-in-westbrook/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1318525_639296-MaineMedBuilding.jpgMaine Medical Center is moving the first of about 500 workers to the largest building in downtown Westbrook, One Riverfront Plaza, seen from across the Presumpscot River.Fri, 26 Jan 2018 16:56:43 +0000Maine churches take flu precautions, urge worshippers to take hands-off approachhttps://www.pressherald.com/2018/01/18/portland-catholic-diocese-warns-against-handshakes-taking-sacrament-by-mouth/
https://www.pressherald.com/2018/01/18/portland-catholic-diocese-warns-against-handshakes-taking-sacrament-by-mouth/#respondThu, 18 Jan 2018 15:48:16 +0000http://www.pressherald.com/2018/01/18/portland-catholic-diocese-warns-against-handshakes-taking-sacrament-by-mouth/Maine churches are suspending traditional rituals such as sharing communion wine and shaking hands to try to prevent the spread of flu as cases of illness and hospitalizations increase rapidly around the state.

The Roman Catholic Diocese of Portland, which covers all of Maine, announced Thursday that parishes would be directed to suspend the sharing of consecrated wine, holding hands during the recitation of the Lord’s Prayer and shaking hands as a sign of peace, among other things. The directives came after Bishop Robert Deeley reviewed reports about influenza from state health authorities, the diocese said.

“If you have watched the news at all, you will know the whole country is in the midst of this flu,” the Rev. Gregory Dube said Thursday during Mass at the Cathedral of the Immaculate Conception in Portland. “We pray for those who are afflicted with this flu, and we will do our best to mitigate our exposure as well.”

It’s not only Catholic churches that are responding. Other churches also are advising against holding or shaking hands, or are keeping hand sanitizer accessible to worshipers.

Churchgoers in Maine are being discouraged from holding hands, a Roman Catholic custom during recitation of the “Our Father.” Staff photo by Gregory Rec

Maine had reported 1,187 cases of people who had tested positive for flu through Jan. 13. Almost all of those cases were H3N2, a virulent strain of influenza A that is more likely to result in hospitalization. By the end of last week, 327 flu cases in Maine required hospitalization, or about 28 percent of the positive flu tests reported to the state.

The number of cases surged last week, with 391 positive tests and 105 hospitalizations reported for the week ending Jan. 13. There are probably more cases that were not reported.

Related

This is the first time since 2009 that Maine’s Catholic bishop has directed parishes to follow the protocols, although individual priests have done so on their own in recent years.

According to Deeley’s directive, parishioners who are sick should stay away from large church gatherings and are not obligated to attend Sunday Mass. Parishes will suspend the sharing of consecrated wine, with the exception of those who must receive from the cup because they can’t receive the host for medical reasons.

Parishioners also will be urged, but not required, to receive Holy Communion in their hands rather than having wafers placed on their tongues. Priests are being advised to be careful not to touch the tongues or hands of communicants.

Deeley also is asking parishioners not to shake hands with each other during the Sign of Peace and instead offer a verbal acknowledgment, smile or bow of the head.

Related

The Rev. Peter Kaseta, parochial vicar at the Parish of the Holy Eucharist, which includes churches in Falmouth, Yarmouth, Gray and Freeport, said the parish implements these changes every year as a precaution. The staff there decided to begin flu season protocols last week.

When Kaseta was ordained 50 years ago, it was rare for parishes to take such steps during flu season. But the announcements have become more common in the past 10 to 15 years, he said.

“I think it’s a good idea,” Kaseta said. “It tells people the bishop is caring and concerned for the health and the welfare of the people in the diocese.”

At daily Mass at the Cathedral in Portland, Rev. Dube announced the protocols would begin Thursday.

When Peter Doyle, of Portland, went to the altar to distribute communion, he took a pump of hand sanitizer from a side table. Doyle said he tries to clean his hands before and after giving out communion at all times of the year.

“I generally avoid shaking hands in the winter anyway,” he said.

Julie Rice of Portland said she is on alert during flu season because she doesn’t want to get her young grandchildren sick. She said most people follow the bishop’s suggestions to prevent spreading germs.

“This is feeling good,” she said.

Carolyn Willard, of South Portland, said the changes during flu season are a way for parishioners to look out for each other, especially the elderly.

“I think it’s more than reasonable,” Willard said. “There are other ways to greet each other and praise God.”

Other churches in Maine also are taking extra precautions to keep members healthy.

At the First Parish Congregational Church in South Portland, anti-bacterial hand sanitizer is placed at both sanctuary entrances year-round to help stop the spread of germs.

The Rev. Deborah Breault of the First Parish Congregational Church of Saco said she plans several steps to encourage members to help prevent the spread of illness, including a reminder to children to cough into their elbows instead of their hands.

At the end of each service, the Saco congregation sings a parting song, “Go in Peace,” and many church members hold hands. Breault said she will include in the weekly bulletin a note suggesting people stop holding hands during the song until flu season is over.

“We want to keep everyone safe and healthy so they can be here,” she said.

Megan Doyle can be contacted at 791-6327 or at:

mdoyle@pressherald.com

Twitter: megan_e_doyle

]]>https://www.pressherald.com/2018/01/18/portland-catholic-diocese-warns-against-handshakes-taking-sacrament-by-mouth/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1318422_980331-2018018_church-flu_1.jpgEucharistic Minister Peter Doyle, right, serves communion Thursday during Mass at the Cathedral of the Immaculate Conception in Portland, placing the wafer into Carolyn Willard's open palms. As the flu season worsens, the Roman Catholic Diocese of Portland and other religious authorities have recommended altering some Mass protocols, such as handshakes during the Sign of Peace, to limit exposure to germs.Fri, 19 Jan 2018 13:27:36 +0000Mercy Hospital receives $5 million gift toward new hospitalhttps://www.pressherald.com/2018/01/18/mercy-hospital-receives-6-million-gift/
https://www.pressherald.com/2018/01/18/mercy-hospital-receives-6-million-gift/#respondThu, 18 Jan 2018 15:42:46 +0000http://www.pressherald.com/2018/01/18/mercy-hospital-receives-6-million-gift/Mercy Hospital in Portland has received $6 million from the Northeast Community of the Sisters of Mercy of the Americas to help build a new hospital at Mercy’s Fore River medical campus and create a permanent endowment for the hospital.

The Sisters of Mercy’s Mercy Endowment Foundation has fulfilled a $5 million pledge to the hospital’s $20 million Fore River capital campaign and announced that it will transfer the foundation’s remaining balance of $1 million to the Eastern Maine Healthcare Systems Foundation for the establishment of a permanent endowment for Mercy Hospital, the hospital said in a statement Thursday. EMHS is the parent company of Mercy Hospital.

The donations were announced Wednesday night at a meeting to mark the hospital’s 100th year of operation.

“We believe Mercy’s healthcare mission is vital to the Greater Portland community,” Sister Jacqueline Marie Kieslich, president of the Northeast Community of the Sisters of Mercy, said in the statement. “These gifts underscore our confidence in the direction of the hospital and our conviction that the ministry of compassionate healthcare for all established in 1918 will continue to flourish through the many people who continue to make Mercy ‘Mercy.'”

The Mercy Endowment Foundation has contributed a total of more than $25 million in today’s dollars to various projects at Mercy Hospital over the years, the statement said.

“We are humbled by these significant gifts,” Mercy Hospital President Charlie Therrien said in the statement. “The Sisters of Mercy started a very special healthcare ministry a century ago in response to Portland’s needs and the urgency of the Spanish flu, and these gifts will help ensure we carry on their legacy for another 100 years.”

In December, Mercy announced that it had filed a letter of intent to consolidate hospital operations on its Fore River campus. The hospital launched a capital campaign last year to raise $20 million to support the project.

“We are committed to stewarding and building the endowment as part of the overall fundraising program for both the capital campaign and ongoing annual fundraising,” said Susan Rouillard, vice president of philanthropy for Mercy. “We are honored the foundation’s trustees have entrusted us to build upon the legacy of the James A. Healy family, whose generosity more than 70 years ago led to the establishment of the Mercy Endowment Foundation which has been shepherded by the Sisters of Mercy.”

]]>https://www.pressherald.com/2018/01/18/mercy-hospital-receives-6-million-gift/feed/0https://multifiles.pressherald.com/uploads/sites/4/2017/06/1208291_mercy.jpgMercy Hospital in Portland, above, is a member of Eastern Maine Healthcare Systems, which experienced an operating loss of $34.3 million during its 2016 fiscal year.Thu, 18 Jan 2018 23:05:30 +0000Walmart touts way to turn unwanted opioids into disposable gelhttps://www.pressherald.com/2018/01/17/walmart-touts-way-to-turn-unwanted-opioids-into-gel/
https://www.pressherald.com/2018/01/17/walmart-touts-way-to-turn-unwanted-opioids-into-gel/#respondThu, 18 Jan 2018 02:27:11 +0000http://www.pressherald.com/2018/01/17/walmart-touts-way-to-turn-unwanted-opioids-into-gel/Walmart is helping customers get rid of leftover opioids by giving them packets that turn the addictive painkillers into a useless gel.

The retail giant said Wednesday that it will provide the packets free with opioid prescriptions filled at its 4,700 U.S. pharmacies.

The small packets, made by DisposeRx, contain a powder that is poured into prescription bottles. When mixed with warm water, the powder turns the pills into a biodegradable gel that can be thrown in the trash.

The move by Walmart is the latest precaution being taken to cut down on opioid abuse. About 4 million Americans are addicted to prescription painkillers, according to the U.S. Drug Enforcement Administration. The agency says these drugs are often obtained from friends and family who leave them in home medicine cabinets.

Research has shown that surgery patients often end up with leftover opioid painkillers and store them improperly at home. Authorities say opioid painkillers should be kept in their original packaging and locked inside a cabinet out of the reach of children.

DisposeRx says its disposal packets also work on other prescription drugs and for pills, tablets, capsules, liquids or patches.

Walmart says its pharmacy customers can request a free packet at any time. The company also will offer a packet every six months to patients with a regular opioid prescription.

Painkiller maker Mallinckrodt PLC has a similar program. It said last fall that it has donated about 1.5 million drug disposal pouches across the country and will increase that total to 2 million early this year.

Some drugstores chains such as CVS and Walgreens also collect unused medications at many of their stores. People can also take leftovers to hospital pharmacies or police stations.

Unused prescriptions also can be thrown in the trash. But the U.S Food and Drug Administration recommends mixing them first with something unpalatable like cat litter or used coffee grounds and then sealing the mixture in a plastic bag.

]]>https://www.pressherald.com/2018/01/17/walmart-touts-way-to-turn-unwanted-opioids-into-gel/feed/0https://multifiles.pressherald.com/uploads/sites/4/2018/01/1318220_Walmart-Opioid_Disposal_12.jpgWalmart will offer packets of the DisposeRx powder at its 4,700 pharmacies to help curb opioid abuse in the U.S.Thu, 18 Jan 2018 12:05:18 +0000Antiabortion activist resigns HHS family planning jobhttps://www.pressherald.com/2018/01/13/antiabortion-activist-resigns-hhs-family-planning-job/
https://www.pressherald.com/2018/01/13/antiabortion-activist-resigns-hhs-family-planning-job/#respondSat, 13 Jan 2018 23:42:49 +0000http://www.pressherald.com/2018/01/13/antiabortion-activist-resigns-hhs-family-planning-job/WASHINGTON — Teresa Manning – an antiabortion activist in charge of the Health and Human Services Department’s family planning programs – resigned her post Friday, according to a department spokeswoman.

Manning, who served as deputy assistant secretary for the Office of Population Affairs, has spent much of her career fighting abortion and has publicly questioned the efficacy of several popular contraception methods. Her job included overseeing the Title X program, which provides family-planning funding for about 4 million poor Americans or those without health insurance.

In an email Friday evening, HHS spokeswoman Caitlin Oakley confirmed Manning’s resignation but did not provide a reason for her abrupt departure.

“HHS would like to thank her for her service to this Administration and the American people,” Oakley said.

Manning was escorted from the building by security officials Friday. According to an HHS official, who spoke on the condition of anonymity, Manning already had turned in her badge and the escort allowed her to get back out through security.

Her resignation does not appear to represent a major ideological shift in the department, since Valerie Huber, a prominent abstinence education advocate, has been named acting deputy assistant secretary for the Office of Population Affairs. Huber has served as chief of staff in the Office of the Assistant Secretary of Health since June.

Manning, who was appointed by President Trump last May, formerly lobbied for the National Right to Life Committee and worked as a legislative analyst for the Family Research Council. She was one of several antiabortion activists and leaders Trump has picked for key positions at the agency.

Like many conservatives who oppose abortion rights, Manning has repeatedly objected to the use of RU-486, or mifepristone, which is often used with misoprostol to trigger an abortion during the early stages of a pregnancy, as well as the morning-after pill.